Physiology Final Exam :)
describe the 4 mechanisms by which increased [K+]ecf increases K+ secretion
-increased Na+/K+ ATPase activity -TEPD is more lumen (due to increased Na+ reabsorption) which favors K+ secretion -increased K+ channels in apical membrane -stimulates aldosterone secretion
what percentage of h2O is reabsorbed in the ascending limb of LOH and what osmolarity?
0% (trick question), mostly solutes absorbed which makes fluid hypoosmotic
how long does gas exchange take in the aveoli
0.25 seconds
how long does gas exchange take in the respiratory zone. what is typical transit time at rest for a RBC through an alveolar capillary
0.25 seconds=gas exchange 0.75 second=transit time at rest
how long is the erythrocyte transit time at rest through a alveolar capillary
0.75 seconds
normal FEV1/FVC=
0.8 80%
what is a measure of forced vital capacity (volume forcibility expired after maximal inhalation) expired in the first second
0.8, 80%
normal lung V/Q is ________ which means there is
0.8, means there is more blood flow than air flow
calcitriol=
1,25 dihydroxycholecalcifero=Vitamin D3
central chemoreceptors are most effective _______ after a change in central CO2
1-2 days after this the kidney resorbs more bicarb
what are all of the proresorptive (calciotropic factors)
1-25(OH)2 vit D3, PTH, PTHrP IL-1 and IL-6 corticosteroids, prolactin
list all 6 events in the cardiac cycle
1. Between beats- passive filling 2. atrial systole- active filling 3. Atrial diastole/early ventricular systole-isovolumetric contraction (increasing ventricular pressure) 4. Late ventricular systole-ejection phase 5. Early ventricular diastole-isovolumetric relaxation (decreasing ventricular pressure) 6. Late ventricular diastole
what are the 3 things that will stimulate granular cells to secrete renin and what are the consequences of renin release
1. Increased Sympathetics 2. Decreased BP, decreased blood volume 3. Decreased flow at macula densa (less NaCl sensed due to decreased GFR, more reabsorbtion) Renin Consequences--->activation of ANG1 and ANG II ANG II---> increases aldosterone release from adrenal cortex(increased Na+), increase in ADH, increase in CO, increase in efferent arteriole resistance/decrease in affferent which will increase GFR
what are the determinants of the resting membrane potential
1. Ion permeability (PK>>>PNa) 2. Na+/K+ ATPase pump activity 3Na out for 2K+ in (maintains concentration gradient and is electrogenic) 3
what are the two levels of effector response
1. Local effector response-how cell (effector) function is changed by the efferent pathway 2. Systemic effector response- how ECF is changed by local effector response
rank the following in terms of Ca++ presence: ECF ICF Bone
1. bone lol 2. ECF 3. ICF
A decrease in MAP with no change in ECF volume or osmolarity will cause what imeddiate responses (don't need to account for renins actions , just what causes renin release)
1. decreased GFR meaning less NaCl to the macula densa. macula densa responds by activation of granular cells in afferent to release Renin 2. drop in BP causes CV control system to respond with increase in sympathetics, increased sympathetics directly activates granular cells to secrete renin 3. drop in BP directly stimulates the granular cells to up renin secretion
what are the TWO MOST IMPORTANT stimuli that increase H+ secretion by tubules
1. increase in Pco2 of ECF 2. Increase in [H+] of ECF
what are the 4 mechanisms by which increased [K+] in the ECF increase K+ secretion in the distal tubule and collecting duct
1. increased Na+/K+ ATPase activity (remember this is on the basolateral, blood side increases to K+ ECF would decrease the gradient for this pump and make it easier for it to work) 2. TEPD is more lumen negative (due to increased Na+ reabsorption) which favors K+ secretion 3. increased # K+ channels in apical membrane(BK and ROMK) 4. Stimulates aldosterone secretion.
how does increased distal tubule flow rate increase K+ secretion (2 things)
1. increased tubule flow rate keeps luminal K+ lower, maintaining the concentration gradient for secretion 2. Increases the number of BK channels in the apical membrane
what are the two sites for digestion of protein and carbohydrates
1. intraluminal (stage I- pancreatic hydrolases)-creates di- and tripeptides, amino acids, maltose, maltotriose, alpha-limit dextrins, glucose, fat digestion completed in lumen 2. mucosal surface(stage II- brush border hydrolases)-end products are amino acids and di- tripeptides, glucose, galactose, fructose
what are the 4 main mechanisms to regulate [Na+] in the ECF
1. osmoreceptor-ADH system 2. the thrist mechanism (1 and 2 are PRIMARY mechanisms) 3. Aldosterone and ANG II(alter mass but not concentration of Na+, changes in Na+ mass are accompanied by volume changes) 4. Salt appetite
what are three things that can affect the excitability of a neuron
1. synaptic input (inhibition or excitation pre or post synpatic) 2. prolonged activation (LTP, LTD) 3. changes in membrane permeability, ion concentration,. other chemicals
what are the different mechanisms of control/limiting clot formation
1. tissue factor pathway inhibitor-secreted by endothelial cells, inhibits the extrinsic pathway(no activation of factor VII) 2. thrombomodulin binding to endothelial cells and prevents platelet activation (thus no VII activation or Xa/Va complex formation) 3. antithrombin III-blocks thrombins actions
what ratio of average daily caloric intake is from protein?
1/6
how many calcium ions are stored in hydroxyapatite? what about phosphate?
10 calcium ions 6 phosphate ions
what are the three processes that faciliate CO2 transport in the body
10% dissolved in plasma 25% binds to aminogroups in Hb (carbaminohemoglobin) Remainder buffered by HCO3- and H+ with carbonic anyhydrase
what percent of total protein digestion occurs in the stomach? What is one important protein that is digested in the stomach?
10-20% Collagen digestion
how many receptor cells for olfactory senses in humans? how many odors can we differentiate?
10-40 million receptor cells (turn over every 60 days) 10,000 odors can be detected
what is the normal PAO2 in respiratory zone
100 mmHg
how many taste buds on circumvallate papillae?
100-200
NFP is normally ______
10mmHg, 125 ml/min, 180 L/day
what percentage of blood is normally in arteries? what about veins?
11% of blood volume in arteries 60% of blood volume in veins
what enzyme converts cortisol to cortisone in aldosterone responsive tissue
11B-hydroxysteroid dehydrogenase converts cortisol to cortisone
how much hours of liver bile secretion can the gallbladder store
12 hours worth 450 ml of concentrated bile
what is the maximal urine concentration
1200 mOsm
what is the maximal urine concentration in humans
1200 mOsm
what is the normal GFR
125ml/min=180L/day entire plasma volume is filtered every 24 mins
what is the normal end diastolic volume
135 ml
what is the normal EDV
135 ml=end diastolic volume
what is normal [Na+] in the ECF
142 mOsm/L lower than this=hyponatremia
anatomic dead is always or
150 ml or 1ml per pound of body weight
how many times can bile salts circulate before being lost in feces?
17x
1M of NaCl will equal what Osm 1M of Glucose will equal what Osm
2 Osm (because Na+ and Cl- dissociate in H2O) 1 osm glucose because it does not dissociate in water
there are ______ sites from digestion of protein and carbohydrates and ______ site for fat
2 sites (intraluminal-stage 1 pancreatuic hydrolases and Stage II mucosal surface brush border hydrolases) 1 site for fats (lumen)
only ______ % of total oxygen content is dissolved in plasma
2%
what percentage of O2 is dissolved in plasma what percentage of O2 is bound to hemoglobin
2%=dissolved 98%=bound to Hb
the face is _______ times as sesnitive to thermal change (WARMING) than the inner mucosa
2-4 times
the face is _____ times as sensitive to thermal change (warming) as the oral mucosa
2-4 times as sensitve
when do A/B antibodies appear
2-8 months after birth, introduced to the immune system through food and bacteria maximum titer is at 10 years of age and then it declines with age
humans function normally with _______ amount of salt
20 meq/day
what percentage of H20 is reabsorbed in the descending LOH and what filtrate osmolarity
20% hyperosmotic
deficiency of what enzyme can cause virilization in newborn females and pseudo-hermaphroditism
21-hydroxylase deficiency
what is normal PTT ? what is normal PT?
22-39 seconds=PTT (intrinsic) 11-15 seconds=PT (extrinsic)
what is normal HCO3- level in ECF?
24 mEq/L of HCO3- anything less than that means metabolic acidosis anything >24 mEq/L of HCO3- is metabolic acidosis
what % of CO is to the liver
27% of resting CO
how much hemoglobin per RBC
2x10^8
how many hours does it take chyme to travel from pyloric valve to the ileoceccal valve?
3-5 hrs
how many mm normally separates the occlusal surfaces of the teeth at REST
3-8 mm remains fairly constant throughout life
how much can cardiac output be increased during intense exercise
30-35L/min normal=5L min
what is normal ECF osmolarity
300 mOsm
what is normal Pc on the arterial and on the venous ends
30mmHg on arterial end 10 mmHg on venous end
what is average skin temperature
34-35 degrees
37⁰ C: 36-37⁰ C: 34-35⁰ C: 33-34⁰ C: 30-34⁰ C: what parts of the body are these normal temps for?
37⁰ C: Core Body Temperature 36-37⁰ C: Tongue 34-35⁰ C: Mucosal surface of lips 33-34⁰ C: Facial skin temperature 30-34⁰ C: Skin temperature
what is the normal ECF K+ in meq/L
4.2 meq/L tightly controlled here
what is the normal PACO2 in the respiratory zone
40 mmHg
what percentages of the medullary interstitial osmolarity is created by urea
40-50%
the Kf of the glomerular capillaries is ________ than any other capillary bed
400x higher than any other capillary bed wayyy more permeable but not variable
what is normal PACO2(partial pressure CO2 in alveoli)
40mmHg
normal PaO2 in veins is normal PCO2 in veins is
40mmHg 45mmHg
at what temp to heat/pain fibers get activated?
45 degrees
how many different receptors create the 1000s of tastes
5 receptors
what is a normal PAO2-PaO2 gradient in a young, non smoker?
5-10 mmHg
what is the only non g-protien coupled serotonin receptor?
5-HT3 is not a GPCR it is a ligand gated ion channel similar to the nicotinic cholinergic receptor
how much endogenous protein is added to the GI lumen and where does it come from
50 g protein added in the form of mucus and enzymes disintegration of the epithelial cells
what is the minimal urine concentration
50 mOsm
what is the minimal urine concentration in humans
50 mOsm
hepatic lymph accounts for ______ % of total body production
50%
how is Ca++ reabsorbed in the TAL and DT
50% by paracellular bulk flow (passive) which is favored by a +8mV luminal charge (created by K+ back leak_ 50% by transcellular entry through channels (passive) then there is a 3Na+/Ca++ transporter and a Ca++ ATPase on the basolateral side the Ca++ ATPase primary transporter is increased by PTH
in 24Hr what percentage of Urea is excreted from the filtered vs reabsorbed
50% is excreted 47 filtered 23.5 reabsorbed 23.5 filtered
describe adaption in olfactory sensation
50% of adaptation is achieved in the first second Further receptor adaptation is limited and slow they use granule cells to inhibit signals
what is tidal volume
500 ml normal inspiration volume
what is the normal ejection fraction
52% SV/EDV
without pancreatic enzymes what happens to fat and protein digestion
60% of fat not absorbed 30-40% protein and carbs not absorbed
What are principal cells in the renal tubules? Where are they found and what do they do?
60-70% of cells in the Late distal and cortical collecting duct of the nephron Act as the site of aldosterone and ADH action Reabsorb Na+ and H2O Secrete K+ IMPERMEABLE TO UREA
what percentage of acid base buffering occurs inside the cells
60-70% the majority occurs here
what is the amount in mosmol of solutes that adults must excrete daily
600 mosmol/day
how much bile does the liver secrete per day
600-1000 ml/day
what is the normal end systolic volume
65 ml
what % of body weight
7% of body weight
what is normal pH?
7.4 anything less than 7.4=acidosis anything greater than 7.4=alkalosis
what percentage of H2O is reabsorbed in the proximal tubule? what osmolarity is the filtrate?
70% isoosmotic
in the veins what is the % of O2 bound to hemoglobin
75%
what is the percent hemoglobin saturated with O2 in veins?
75%
how long does it take contents to move from ileocecal valve to the ANUSSSSS
8-15 hours
fixed or non volatile acid production in the body adds how much H+ per day? what is the concentration in the ECF normally?
80 mEq/day which needs to be secreted because normally its a super small concentration
Chromafin cells secrete what ? (with %). What receptors are activated?
80% epinephrine 20% NE into bloodstream Adrenergic receptors are activated
what percentage of blood fills ventriculars between beats
80% of blood
myogenic regulation will work within what blood pressure range
80-180 it will maintain constant blood flow to organs
what is the normal MAP myogenic range
80-180 mmHg flow remains constant by altering VSM and thus radius of vascular tissue
what is the myogenic autoregulatory range
80-180/200
where are MOST proteins digested?
80-90% in small intestine by small peptides and amino acids produced by Trypsin, Chymotrypsin, Carboxypolypeptidases and and elastase on the luminal side and brush border peptidases produce amino acids
how many different adrenoreceptors that can bind NE and epi
9 different ones that are all G-prot coupled but with different G-proteins
what are the components of plasma?
92% H20 7% protein=plasma proteins 1% dissolved substances (organic molecules, ions, trace elements, vitamins, dissolved gases)
what is the percent hemoglobin saturated with O2 in arteries
97%
what time of day is their the highest TSH secretion
9:00 pm it starts to rise and it peaks at midnight and declines during the day
systemic hypertension from obesity or pregnacy (or even after deep insipriation) would cause a ________ shift to the mean electical axis of the heart
<59 left shift
at what PaO2 is there a large increase in ventilation due to peripheral chemoreceptor response
<60 mmHg remember that normal is 95 mmHg
FEV1 is _________ in obstructive lung diseases
<80%
what are the Gq-coupled hormone receptors, what second messengers
A adrenergic, angiotensin II, TRH activate IP3, DAG and Ca2+
what are the differences between A and B antigens and the Rh antigen
A and B do not require prior exposure to have antibodies but Rh does Rh is IgG while A/B are IgM Rh produces a mild agglutination response in Rh negative persons first response is usually mild Rh antigens can cross the placenta but A and B cannot
what are the mass action model equations
A+B<--->C+D where K1(rate of forward)=K2(rate of reverse) P+S<--->PS where K1=K2 and P=protein with binding site S=substrate (specific substance) PS=protein bound to substrate
what are the fat soluble vitamins
A, D, E, K
what is the universal acceptor?
AB+
what causes bronchoconstriction
ACH on M, increased O2, decreaed CO2 and histamine
preganglionic terminals of both sympathetic and parasympathetic cells release what? What does it bind
ACh binds nicotinic receptors
PNS postganglionic release what and what does it bind to
ACh which binds muscarinic receptors on target cells
what are the vasoconstricting hormones for reflex control
ADH ANGII
what does ADH do to interstitial osmolarity and urine osmolarity
ADH increases both interstitial and urine osmolarity
what carriers does ADH activate in the medullary collecting duct cells that help contribute to the hyperosmotic interstitial fluid
ADH will activate UT-A1 and UT-A3 for facilitated diffusion of urea by medullary collecting duct cells
List all hormones produced by the posterior pit
ADH=vasopressin Oxytocin
where is sodium reabsorbed in a nephron? what pathways does it use?
ALL ALONG THE NEPHRON transport occurs transcellularly and paracellularly
during artial diastole/early ventricular systole what valves are close?
ALL OF THEM, isovolumetric contraction, increase in pressure in ventricles
intrinsic factor secretion by oxyntic cells is stimulated by ___________
ALL THE SAME SECRETEAGOGUES AS HCl Gastrin, Histamine, ACh
what is AME and what causes it?
AME=apparent mineralcorticoid excess can be caused by deficiencies in the 11B-HSD enzyme
what are the vasodilators hormone for reflex control
ANP
Atrial Natriuretic Peptide acts on the ________ part of the nephron and results in _________
ANP acts on late DT and collceting duct and results in decreased NaCl reabsorption
what happens when there is an increase in blood volume with no change in osmolarity
ANP is released from artia cells from increased stretch ANP inhibits ADH secretion increases GFR and decreases renin (less aldosterone) decreases blood pressure through NaCl and H2O secretion
cortisol will do what to insulin (what is the ultimate outcome in the heart, brain and skeletal tissue
ANTI insulin action=DECREASES glucose uptake in muscle and fat but NOT in the brain and heart
unlike most sensory modalities pain can be evoked by _________ if it is strong enough
ANY stimuli (mechanical, thermal, or chemical)
Give mechanism for contractile heart muscle contraction
AP enters causing Ca+ to flow into the cell (through v-gated L-type Ca+ channel_ which activates a ryanodine receptor channel on the SR which releases more Ca++(calcium induced calcium release) into the ECM and causes contraction
describe AP transduction in the SR
AP travels down the membrane, down the T-tubules, and activate voltage sensitive dihydropyridine receptors on the T-tubules These in turn open calcium channels (ryanodine receptors) on the SR to the sarcoplasm calcium goes from the SR to the sarcoplasm
what type of aquaporin is inserted into the apical (luminal) membrane in the late DT and CD in presence of ADH
AQP-2
what must be present to release myosin from acitn
ATP
what are examples of rapid acting NTs (small molecule)
Acetylcholine, Norepinephrine, Dopamine, Serotonin (5-HT), Histamine, Glycine, GABA, Glutamate, Nitric Oxide (NO).
at rest which levels will be higher Ach or NE and what does this mean for heart control
Ach (parasympathetics) thus parasympathetics control heart rate at rest
what neurotransmitters are involved in stimulation of parietal and chief cells in response to stretch of the gastric wall?
Ach and GRP(gastrin releasing peptide)
give a mechanistic explanation for parasympathetic control of heart rate
Ach binds muscarinic receptors which decrease the permeability of the Na+ F type channel and increase the permeability of the K+ channel hyperpolarizes the Vm
what things can cause bronchoconstriction
Ach on M, increase in O2 and decrease in Co2 histamine release
what is the equation for affinity?
Affinity alphax1/Kd Kd=ligand concentration at 50% receptor occupation
Which receptor acts to do SNS vasoconstriction? What about vasodilation (SNS)
Alpha 1-vasoconstriction Beta 2- vasodilation
which receptor is involved in the negative feedback pathway of NE release
Alpha 2 blocks NE release when activated
what cells have primary active transport of H+ across the apical membrane and can secrete H+ agains a huge gradient 1000:1 (hint: cell type in Late distal/CCD)
Alpha intercalated cells (act to secrete H+ and reabsorb K+ and HCO3- in acidosis) trying to get rid of excess H+ to raise pH of blood
which substances have a greater reabsorption rate than H2O in the proximal tubule
Amino acids, Glucose, and HCO3-
which ion determines the amount of NT released at a synapses
Amount of Ca++ dictates the amount of NT that gets released
what is the MAJOR regulator of Na+ and water rebsorption
Angiotensin II
what are the things that rate of gas diffusion is dependent on
!. Partial pressure gradient 2. Solubility of Gas in Fluid (S) 3. Cross sectional area of membrane 4.. Distance of Diffusion 5. Molecular Weight of Gas V=delta P x A x S/ d x MW^0.5
what is the equation for airflow resistance
(Patm-Palv)/Resistance R=8nl/pi x r^4
what is the equation for net filtration pressure
(Pc-Pi) - (πc-πif) or Pc+piIF - PIF - piC its the sum of filtration forces subtracted by the absorptive forces can also be multiplied by Kf to account for water permeability of capillary
alveolar ventilation=
(tidal volume - anatomic dead space) x respiration rate
what is the normal threshold potential
-50mV
Dysdiadochokinesia= damage to what can cause this?
Inability to perform rapid alternating movements. cerebellum
what are GHs effects in chondrocytes
Inceased AA uptake increased protein synthesis
functions of the enteric nervous system
Increase tone of gut wall Increase intensity of rhythmic contractions Slight increase in rate of rhythmic contractions Increase conduction velocity of electrical waves along gut wall Inhibition of sphincter contraction
GI system physiological effects of thyroid hormones
Increased appetite and food intake Increased rate of secretion and motility of the GI tract (i.e. hypothyroidism can produce constipation
endocrine system physiological effects of thyroid hormone?
Increased glucose consumption results in increased insulin secretion Activation of bone formation causes a need for increased PTH secretion Causes increased inactivation of glucocorticoids which lead to more ACTH release.
cardiovascular system physiologica effects of the thyroid hormone
Increased β-adrenergic receptors Increased blood flow, heart rate, and heart contractility.
Release of secretory products from mast cell granules causes: type I hypersensitivity
Increases vascular permeability, vasodilation, bronchial and visceral smooth muscle contraction, salivary and bronchial secretions, and inflammation INCREASES respiratory resistance, DECREASES BP
what is the late phase reaction of type I hypersensisitivty
Inflammatory infiltration of eosinophils, basophils, neutrophils, and lymphocytes 2-4 hours after degranulation of mast cells & basophils This stage is capable of damaging tissue
what are factors that decrease the ECF K+ concentration?(shifts K+ into cells)
Insulin aldosterone B-2 adrenergic stimulation alkalosis decreased ECF osmolarity
what three hormones are increased in response to thyroid hormone release and why?
Insulin-increased glucose consumption leads to increase in insulin PTH-increased in response to activation of bone formation ACTH-increase caused by increased INACTIVATION of glucocorticoids (no negative feedback)
smooth muscle ______ require a vm change
It does not require
increased hematocrit will do what to TPR. What would it do to CO? what about MAP?
It will increase TPR (increased viscosity will increase resistance) It will do nothing to CO (trick question bitcchhhh) and it will increase MAP because increasing TPR will increase MAP MAP=COxTPR
the PAO2-PaO2 gradient will ________ with increased age?
It will increase! with age less ability to uptake O2
what receptors cause rapid, shallow breathing AND a sense of dyspnea (difficulty breath)
J receptors respond to inflammatory processes (edema, pneumonia and congestive heart failure)
a strong tap on the chin will cause what reflex and why?
Jaw Jerk Reflex strong tap will stretch the jaw closers and they will respond by contraction so that the jaw closes STRETCH reflex
Dysarthia:
Jumbled vocalization; failure to progress in talking.
which nephron class makes up only 20-30% of nephrons and is important in concentrating urine, has a glomerulus near cortex/medulla border. Long loops of henle and a vasa recta blood system
Juxtamedullary
what creates the postive voltage gradient in the tubular lumen of the TAL
K+ back leak
[K+] is _______ in the ECF than in the ICF
K+ concentration is lower in the ECF than the ICF this means it wants to move out of the cell down its concentration gradient
what is more permeable to the cell membrane? K+ or Na+? so which is more important in determining resting membrane potential?
K+ is WAYYYY MORE permeable thus K+ is more important in determining resting Vm
what is the relative concentrations of following ions in the ECF vs ICF [K+] [Ca++] [Mg++] [Cl-] [HCO3-]
K+ is higher in the ICF Ca++ is higher in the ECF Mg++ is higher in the ICF Cl- is higher in the ECF HCO3- is higher in the ECF
where is K+ reabsorbed and secreted in the nephron? where does aldosterone act
K+ is reabsorbed in the PCT (65%) and the TAL (27%) K+ is secreted in presence of aldosterone in the distal tubule/collecting duct
what active transporter is needed on the basolateral side of intestinal cells to assist with
K+/Na+ ATPase to drive the gradient for secondary active sodium transport of glucose and galactose on the apical side
GFR=
Kf x NFP (net filtration pressure) NFP=glomerular hydrostatic = bowmans capsule pressure - glomerular colloid osmotic pressure
what is the MOST powerful Acid/Base regulatory mechanism
Kidney excretion of H+
what channels control contractibility of the heart
L type voltage gated Ca++ channels, these can be increased (+ionotropic agents) or decreased by -ionotropic agents
what calcium channels are used to bring Ca++ into the ICM from the ECM and what increases these channels permeability
L-type Ca++ channel binding of the B-adrenergic receptors by norepinephrine or epi will lead to activation of cAMP dependent kinase which will increase the L-type Ca2+ channel permeability this also increases the INTRAcellular Ryandodine channel that releases Ca2+ from the SR
in the pertibular capillaries there is _______ Kf due to _______ and _______ colloid pressure of the capillary due to ________
LARGE Kf=high surface area and permeability Large colloid osmotic pressure of capillary due to volume lost during filtration
nociceptive thermal receptors have ________ receptive fields in the orofacial region but other thermoreceptors have
LARGE receptive fields for nociceptors Small for thermal receptors
lungs with a lower compliance like pulmonary fibrosis would require a ________ transpulmonary pressure to increase volume
LARGER transpulmonary pressure
at High PO2 oxygen is ________ likely to dissociate from hemoglobin
LESS LIKELY HIGHER AFFINITY High PO2=Higher Hb affinity for O2 Positive cooperativity
what are examples of neuropeptide NTs
LH, ACTH, GH, vasopressin, oxytocin, angiotensin II, substance P
PNS has ________ preganglionic axons than SNS
LONGER
taste specificity is best at _______ ligand concentrations
LOW
what are the things that peripheral chemoreceptors are sensitive to?
LOW PaO2 HIGH PaCO2 LOW pH (high H+) ONLY SENSITIVE TO DISSSOOLVVVEDDD GASSSES
compared to systemic circulation list differences in pulmonary circulation
LOW RESISTANCE LOW PRESSURE 25/8 MAP =14mmHg LOWER VOLUME HIGHER COMPLIANCE ARTERIES/CAPILLARIES
cephalic(20%) and gastric phases(5-10%) regulation of pancreatic secretion both cause what through a vagovagal reflex
LOW VOLUME, HIGH Enzyme secretion (Ach/GRP
lower affinity ligands will have what KD? what about higher affinity ligands?
Large Kd=low affinity Low Kd=high affinity
what are features of the cells in the proximal tubule (PT=PCT(early) + PST(late))
Large number of mitochondria Large surface area on both apical and basolateral membranes Large number of membrane proteins High permeability for H2O
why are neuropeptide NTs slower acting
Larger molecules Produced in the cell body and transported down the axon via axonal streaming. Fewer neuropeptides produced and released
where is the only place you would find the secondary active Formate/Cl- antiporter(be specific af bro)
Late proximal tubule on the apical side Reabsorbs Cl- transcellulary and excretes formate
what helps improve sensory acuity and discrimination?>
Lateral inhibition Small receptive fields with overlap
what part of the premotor cortex determines the overall motor plan? What part activates the primary motor cortex?
Anterior premotor area-determines plan Posterior premotor area activates the primary motor cortex to activate muscles
increased Pc could happen from ????
Arteriolar dilation venous constriction increased venous pressure heart failure
vascular resistance is highest in the
Arterioles
where is ANP released from? artria or ventricles?
Artria
Describe permeability to H20 in the following Ascending Limb of Loop of Henle Collecting Duct Proximal Tubule
Ascending Limb of Loop of Henle=NOT PERMEABILE TO H2O Collecting Duct= Only permeable when ADH is present Proximal Tubule=HIGHLY permeable to H2O
what will happen if there is an increase in blood volume with no change in osmolarity
Atrial myocardial cells stretch and release ANP ANP acts on 4 things hypothalamus(integrating center)-decrease ADH Kidney(effector)-increased GFR(NaCl and H2O excretion), decreased renin(less aldosterone) Adrenal Cortex(integrating center)-less aldosterone Medulla oblongata-Decrease BP
what are the functional areas of the medulla oblongata
Autonomic control centerals Nucleus Raphe Magnus and Rostral Ventromedial Medulla Medullary Reticular Nuclei Pyramids Nuclei for the Reticular Formation
what are the three levels of control of renal blood flow and GFR
Autoregulation -Myogenic autoregulation -keeps F=RBF and GFR -Tubuloglomerular Feedback- ensures nearly constant delivery of Na+ and Cl- to the distal nephron via the juxtaglomerular apparatus Local Control-paracrines and autocrines, endothelin, prostaglandins, NO and bradykinin, dopamine Systemic control- symapthetic NS and epi. renin-ang, ANP
describe what happens when B cell are activated
B cells enlarge and look like lymphoblasts some b cells differentiate into plasmablasts which later become plasma cells (one plasmablast can turn into a shitttt load of plasma cells)
what are Gs coupled hormone receptors and what second messenger do they use?
B-adrenergic, calcitonin, ACTH, glucagon, TSH, Vasopressin) second messenger cAMP
what sympathetic receptors act on the heart
B1-Increasing HR and contractibiltity B2-vasodilation
describe the long and tedious process of vitamin B12 (Cobalamin) absorption
B12 is liberated from prots by acid in stomach, it then binds R-binding protein (protects B12 from low pH) in duodenum- protesases digest R-binding protein and B12 binds intrinsic factor in illeum- intrinisc factor binds IFCR and is uptaken into cells intrinsic factor is degraded and B12 binds TCII and complex crosses into blood via exocytosis
What receptor acts to cause bronchodilation
B2
what receptor causes bronchial smooth muscle dilation and coronary blood flow dilation?
B2
what receptor is responsible for increases coronary blood flow
B2 (adrenergic, sympathetics)
what are quick relief mediations for atopic asthma
B2 agonists and anticholinergic agents
what are bile acid sequestrants
BARI durgs (inhibit bile salt recycling and lower LDL) this binds to bile salts in the lumen and block thier transport back in by ASBT transported
what is the feeding pattern of the small intestine
BER slow waves in the small intestine intersitital cells of cajal 3-12 waves/min controlled primarily by the enteric NS stimulated by: distention nutrient content of chyme gastroenteric reflex-short feedback loop from stomach to SI hormones, stimulated by CCK, Gastrin, insulin and serotonin INhibited by secretin and glucagon
Where does calcium come from to create heart muscle contraction?
BOTH the SR via ryanodine receptors and ECM via L-Type Ca2+ receptor
what renal arteriole does the sympathetic nervous effect?
BOTH the afferent and efferent arterioles but SNS only plays a minor role renal autoregulation smooths normal SNS induced changes in arterial pressure and CO
what aquaporins are always present on the basolateral side of the late Distal tubule and collecting duct? what aquaporins are only present on the APICAL side in the presence of ADH
Basolateral always has AQP-3 and AQP-4 Apical has AQP-2 insertion with ADH
what transporters does ang II increase in renal proximal, loop, distal and collecting tubules
Basolateral side: Na+/K+ ATPase and Na+/HCO3- symporter Apical Side: Na+/H+ NHE H+ secretion
To be perceived, odorants must
Be volatile (spread in air—small) Be partially water-soluble Be partially lipid-soluble Reach olfactory mucosa (normal breath vs. sniff)
for ordorants to be perceived what qualifications must be met?
Be volatile (spread in air—small) Be partially water-soluble Be partially lipid-soluble Reach olfactory mucosa (normal breath vs. sniff)
what receptor controls sympathetic heart actions. What receptor causes vasodilation of the coronary arteries
Beta 1 Increases HR and contractility Beta 2-vasodilation
which adrengic receptor causes smooth muscle relaxation?
Beta 2
where does 2,3 BPG bind specifically
Beta subunits of deoxy HB and decreases O2 affinity MORE O2 unloading remember that fetal hemoglobin does not have beta subunits so it is unaffected by 2,3 bpg
what ions would be increased and what which would not be present in a alkalosis patients urine
Bicarb (HCO3-) would be increased in urine and no new HCO3- would be added to ECF No NH4+ or H2PO4- No non volatile acids secreted not all filtered HCO3- is reabsorbed and HCO3- is secreted
at high secretion rates in the pancreas describe bicarb and cholride concentrations
Bicarb is high chloride is low
what low secretion rates in the pancreas describe bicarb concentration
Bicarb is low chloride is high
BARI drugs are
Bile acid reabsoprtion inhibitors durgs that inhibit bile recycling used to lower LDL levels in the blood hepatocyte production of bile increases 6-10x if bile salt recycling is reduced LDL taken up form the blood via hepatocytes
describe the basic mechanism of G prot linked taste reception
Binding of molecular to T1R or T2R causes IP3 signaling which stimulates the release of Ca2+ into the cytosol which activates TrpM5 receptor which depolarizes the cell and allows pannexin channel to open and release ATP which binds to purinergic receptors
what local controls will decrease ONLY the resistance of the afferent arteriole and increase GFR
Bradykinin, PGI/PGE (prostaglandins) maybe dopamine (it can vasoconstrict and dilate)
what produces monosaccharides in the small intestine and where does this occur?
Brush border hydrolases produce monosaccharides
what are oral symptoms of hyperthyroidism
Burning Mouth Syndrome Gum disease Excessive salivation Weakening of mandible(increased bone turn over) Increased caries risk
what are the two stimuli for acini cell enzyme secretion
CCK ACh/GRP (vagovagal reflex, long)
what are the two stimuli for acini cell secretion
CCK ACh/GRP via the vagovagal reflex
what can cause gallbladder contraction
CCK vagal stimulation can cause WEAK contraction
what enterogastrones are secreted in the duodenum in response to nutrients and or acids in chyme what do these do to gastric
CCK (released with Fat or protein in lumen of duodenum) Secretin (Acid) GIP (Carbohydrate) decrease gastric emptying
what secretions are in the duodenum
CCK , Secretin, GIP, HCO3-
what hormones stimulate the feeding pattern in the SI
CCK, Gastrin, Insulin and serotonin
what hormones will stimulate small intestine feeding pattern
CCK, Gastrin, Insulin and serotonin
CCK-RP is released on the _________ side of the epithelium and CCK is released on the ________
CCK-RP is lumenal CCK is blood because its a hormone
what receptor binds gastrin? what stomach cells have this?
CCK2 binds gastrin ECL cells and parietal (oxyntic) cells
what type of cells are involved in Type IV (delayed) hypersensitivity (contact dermatitis)
CD4 and CD8 (cytotoxic) t cells produce a cell mediated reaction stimulating macrophage recruitment and inflammation
CD4 cells interact with MHC class _______ CD8 interacts with MHC class ______
CD4(helper t)-MHC Class II from APCs CD8(cytotoxic t)- MHC Class I from all sorts of cells
CD8 cells bind _______ CD4 cells bind ______
CD8=MHC Class I CD4=MHC Class II
what are causes of secondary hyperaldosteronism
CHF Cirrhosis Nephrosis Renal artery stenosis
which cranial nerves innervate the peripheral chemoreceptors
CN IX-from the carotid bodies CN X-from the aortic bodies
what is the nerve pathway for the olfactory systems concious perception and anaylsis of olfaction
CN1--->lateral olfactory area--->newer system--->orbitofrontale cortex
what is the nerve pathway for olfactory reflexes
CNI---->medial olfactory area/primitive olfactory system to the hypothalamus and limbic system
what is the nerve pathway for olfactory systems automatic but learned control of food intake and aversion to toxic and unhealthy foods?
CNI--->lateral olfactory area--->the less old olfactory system-->to limbic system--->hypothalamus
what cranial nerves carry parasympathetics
CNIII, CNVII, CNIX, CNX
interneurons are only found where
CNS
which nerve provides taste to the papillae on the soft palate?
CNVII facial greater petrosal superficial branch
what cranial nerves are involved in taste transmission into the CNS
CNVII-facial nerve, chorda tympani branch ant 2/3 greater petrosal superifical nerve for papillae on soft palate CNXI-glossopharyngeal, posterior 1/3 of tongue Vagus nerve-pharynx, epiglottis and larynx
flow into systemic arteries =
CO or CO=HR x SV
what are the vasodilating paracrines
CO2 H+(lactic acid) Adenosine (ATP--->adenosine) K+ (from multiple APs) Prostaglandins Bradykinin NO
how does H+ enter cells
CO2 (carbonic anyhydrase reaction) produced by latic acid H+/K+ exchange on prots
what is the CO2 + H20 bicarbonate reaction what catalyzes the formation of H2CO3(carbonic acid) (which dissociates into HCO3- and H+) how is hemoglobin and Cl- involved in this in systemic tissue
CO2 + H2O<--->H2CO3<--->HCO3- + H+ carbonic anhydrase catalyzes H+ combines with hemoglobin for buffering HCO3- moves into plasma in exchange for Cl- via the BAND 3 protein
CO2 is_______ soluble than O2 thus it will diffuse _______
CO2 is more soluble thus it diffuses more rapidly than O2
give the CO equation in terms of TPR and MAP
CO= MAP/TPR
alright one more time CO= MAP= SV= TPR=
CO=HR x SV SV=EDV-ESV MAP=COxTRP TRP=sum of all arterial resistance
what is the cardiac output equation. What is CO
CO=HR x SV CO=amount of blood pumped out of each ventricle in 1 minute
MAP=
COxTPR
give the mechanistic explanation for how the jaw muscles respond to chewing harder objects
CPG starts cyclical motion of the chewing when met with a hard object the force of contraction cannot overcome the load (isometric contraction) but intrafusal fibers of the muscle spindle are still contracting and stretching the muscle spindle so further contraction of the muscles is stimulated constant feedback from muscle spindle allows muscle to overcome the load of the hard object (isotonic contraction) chewing hard food again will allow the response to be greater and matches loading response quicker
what hormone causes the release of ACTH?
CRH from the hypothalamus
what stimulates formation of leukocytes
CSFs and ILs
how is calcium removed to relax smooth muscle
Ca is returned to SR via Ca++ATPase and to the ECFvia Ca++ ATPase AND Na+/Ca++ exchanger
what returns Ca++ to the ECF in smooth muscle what returns Ca++ to the SR
Ca++ ATPase AND Na+/Ca++ exchanger-->ECF Ca++ ATPase --->SR
describe mechanistically smooth muscle contraction
Ca++ binds calmodulin to activate it calmodulin activates MLCK MLCK phosphorylates myosin and caldesmon and calponin to inactivate them caldesmon inactivation allows actin/myosin bind calpon inactivate myosin ATPAse
what ions are actively reabsorbed in the small intestine? (besides Na+ and Cl-)
Ca++, PO4--- Mg++ Fe++
what is hydroxyapatites formula
Ca10 (PO4)6 OH(2)
what are the channels that control the AP in AR cells
Ca2+ (L)=long lasting voltage gated Ca++ channel K+ channel=voltage gated K+ channel
in cardiac muscle Ca2+ ATPase channel is found on the _________ and the Ca2+/Na+ pump is found on _______
Ca2+ ATPase returns Ca2+ to the SR Ca2+/Na+ returns Ca2+ to the ECF THESE ARE BOTH USED FOR REMOVING CA2+ and THUS STOPPING cardiac contraction
what plasma membrane pumps act to remove Ca++ in heart muscle relaxation?
Ca2+/Na+ secondary active antiporter 1 Ca2+ out (against gradient) for 3 Na+ (down gradient) Na/K+ ATPase pump acts to remove excessive sodium
what are the three ways calcitrol increases intestinal absorption of calcium
Calcium binding protein production calcium stimulated ATPase alkaline phosphatase
what activates myosin light chain kinase? what does this mean for relaxation?
Calcium bound to calmodulin MLCK activated will caused contraction (allows actin, myosin binding through phosphorylation) the only way to completely relax is to remove calcium completely
which is more tightly controlled? phosphate levels or calcium?>
Calcium is more tightly controlled
duration of feeding pattern depends on what 2 things?
Caloric content of meal Nutrient composition of meal
what substance makes up half of our daily caloric intake?
Carbohydrates
which type of shock is from pump failure of the heart
Cardiogenic shock MIs can cause
what are some cardiovascular actions of T3/T4
Cardiovascular-increased output, increased tissue blood flow, increased heart rate, increased heart strength and increased respiration
which peripheral chemoreceptor can increase its rate of firing in response to an increase in arterial pH that IS INDEPENDENT of CO2 control mechanisms
Carotid bodies
Striatum =
Caudate + Putamen basal nuclei
which receptors are MOST important for minute to minute control of breathing and what are they sensitive to
Central Chemoreceptors- extremely sensitive to csf H+ levels (ONLY THESE) nothing else
what are the phases of GI activation?
Cephalic phase via vagus nerve Gastric phase (local nervous secretory reflexes, vagal reflexes, gastrin-histamine stimualtion) intestinal phase(nervous mechanisms and hormonal)
To change membrane potential you need to do one of what two things
Change the membrane's permeability to an ion (open/close a channel, or change activity of an active transporter) Change the ion concentration gradient across the membrane
what are the systems that regulate H+ in body fluids in order of fastest to slowest
Chemical-acid/base buffer systems, instantaneous Respiratory System- regulates removal of CO2(H+) changes alveolar ventilation and works in seconds to minutes Kidneys- excrete acidic or alkaline urine, hours to days "slowest" BUT MOST POWERFUL of the systems
explain why their is more Cl- reabsorption in the distal portion of the PCT than in the proximal portion. Why is urea also reabsorbed more in the distal portion?
Cl- has three fold reason for being more easily reabsorbed in the distal portion of the PCT. There is a more negative lumen potential from loss of Na+ and a higher Cl- concentration due to h2O loss, this creates a gradient for Cl- reabsorbtion. Also the distal portion has transcellular formate/cl- transport. Urea has increased reabsorbtion due to loss of H2O
what are all of the effects of GH excess
Coarse facial features (large fleshy nose, frontal bossing, jaw malocclusion) Cardiomegaly (hypertension)=coronary heart disease Barrel chest Kyphosis Increased size of hands and feet Male sexual dysfunction Degenerative Arthritis Paresthesias (peripheral neuropathy) Thickened skin Hyperhidrosis and oily skin
what receptor is sensitive to menthol and decreases the threshold of channels so that warmer compounds are perceived as cold
Cold-menthol Receptor Type I TRPM8
what are the absorptive Starling Forces governing bulk flow
Colloid Osmotic Pressure in Capillary-28mmHg Hydrostatic Pressure of the Interstitial fluid- -3mmHg
describe how T3 and T4 are secreted into the blood starting from the colloid
Colloid is internalized via pinocytosis the vesicles fuse with lysosomes in the cell Proteases cleave T3 and T4 from TG T3 and T4 diffuse out of the cell and into the capillaries
the submucosa is the _______ layer with _________ vessels
Connective tissue layer with blood and lymph vessels also has submucosal plexus of neurons communicates with muscularis mucosa(villi in mucosa) and to the myenteric plexus of the muscularies externa
muscarninc receptors (G-prot/metabotrophic) have what possible functions
Constricts smooth muscles, relax sphincters stimulate glandular secretions
which nephron class makes up the majority of nephrons (70-80%) and has glomerulus in outer cortex, SHORT loops of henle and peritubular capillaries
Cortical nephrons
what are three things that the membrane potential can do?
Creates electrical gradients for movement of ions into/out of cells. Opens or closes gated ion channels. Regulates exocytosis
what solutes have a lower Absorption rate than the H2O absorption rate in the PROXIMAL TUBULE
Creatinine (NO reaborption) Urea Cl-
Low ASBT Activity Associated with:
Crohn's disease Congenital 1° bile acid malabsorption Idiopathic chronic diarrhea Irritable Bowel Syndrome
what pathway do NSAIDs(aspirin, naproxen, ibuprofen) work on
Cyclooxygenase (COX) NSAIDs nonselectively inhibit both COX-1 and COX-2 pathways prevents formation of prostaglands and thromboxanes
type II hypersensitivty
Cytotoxic - Mech: Preformed IgG & IgM Ab that react w/Ag --> 2ndary inflammation - Ex: AI hemolytic anemia, cytopenis from Ab, Transfusion rxn, Erythroblastosis fetalis, Goodpasture, MG, Graves, pernicious anemia, pemphigus vulgaris, hyperacute transplant rejection
what cells release somatostatin?
D cells in response mainly to luminal H+
the thickness of jaw muscles _______ signifcantly with age
DECREASES
increasing hematocrit will do what to turbulent flow
DECREASES Re=Vdp/n n=hematocrit
PGE2, PGI2 will do what to renal arterioles and what is the effect on RBF and GFR
DECREASES AFFERENT ARTERIOLE resistance increased RBF and increased GFR
what type of somatic pain can be referred? what about visceral?
DEEP SOMATIC BOTH TYPES OF VISCERAL (TRUE AND PARIETAL)
what are the actual sex hormones released by the zona reticularis?
DHEA and androstenedione (GETs converted to testosterone and 5-dihydrotestosterone in peripheral tissues)
distention directly acts on what two things during the gastric phase of acid secretion?
DIRECTLY acts on enteric neurons and DIRECTLY stimualtes G-cells to produce gastrin keep in mind that indirectly those two things will activate all the cells in the acid release pathway and greatly increase HCl production
Diffusing capacities, DLCO2 cannot be calculated easily becasue ______ and DLO2 is difficult to calculate because __________ so Carbon monoxide is ideal because ______
DLCO2 cannot be calculated because of rapid diffusion DLO2 is difficult because most O2 binds to hemoglobin Carbon Monoxide is ideal because it is diffusion limited
acitvation of central chemoreceptors will stimulate
DPG, increase rate of breathing and depth
What are the actions of the PNS via muscarinic receptors?
DUMBLES Digestion Urination Miosis Bronchoconstriction, Bradycardia Lacrimation Salivation
Amorphosynthesis=
Damage to the somatosensory association area on one side results in inability to recognize complex objects and forms felt on the opposite dise of the body lose of sense of form of their own body on the oppositie side
what four things can cause a left shift to the oxyhemoglobin dissociation curve
Decreased PCO2 increased pH (ex 7.6) Decreased temperature decreased 2,3 BPG
what are the stimuli for decreased H+ secretion and HCO3- reabsorption
Decreased Pco2 (alkalosis) decreased H+(alkalosis), increased HCO3- (alkalosis) increased ECF volume decreased ANG II decreaed aldosterone hyperkalemia
what are the MAP equations
Diastolic P + 1/3 (systolic P - diastolic P) MAP=CO x TPR
what are the effector responses for Atrial Natriuretic Peptide release
Directly inhibits Na+ and H2O reabsorption increases GFR(dilation of afferent and constriction of efferent arterioles) INHIBITS renin release and aldosterone formation helps to minimize blood volume expansion
why is summation of EPSP sometimes necessary to intiate an AP
Discharge of one pre-synaptic neuron cannot reach threshold (+20 mV more positive than rest). The diameter of the soma is large causing almost no resistance to electric current flow through the soma, which allows for summation to occur.
which part of the proximal tubule reabsorbs more Cl- and urea? which part reabsorbs all glucose, amino acids and 65% HCO3-
Distal portions-MORE Cl- and Urea proximal protions=all glucose, amino acids and 65% HCO3-
smooth muscle automatic motor neurons do not form _______ and the axons have ________
Do not form synapses and axons have varicositites
describe what happens in the thin ascending limb
Does not reabsorb significant amounts of any solutes impermeable to water urea secretion via facilitated diffusion
what are the vasodilators in the pulmonary arterioles
Dopamine Bradykinin Prostacyclin Nitric Oxide Histamine (H2) Acetylcholine HIGH O2
which medullary respiratory center is the central pattern generator for breath
Dorsal Respiratory Group-nucleus of the tractus solitarius
the drop in cardiac output following a hemorrhage is most directly related to what CO factor?
Drop in SV heart rate isnt impacted until reflex mechanisms kick in
Clinical Abnormalities Resulting from Cerebellar Damage
Dysmetria: Undershoot or overshoot of intended position with the hand, arm, leg or eye. Due to loss of the ability to predict how far movements will go. Overshoot occurs which appears as an intention tremor. A type of ataxia, which is lack of coordination of muscle movement. Dysdiadochokinesia: Inability to perform rapid alternating movements. Dysarthia: Jumbled vocalization; failure to progress in talking. Nystagmus: Tremor of the eyeballs
enterochromaffin like cells=
ECF cells secrete paracrine histamine
ADH controls both
ECF osmolarity (decreased osmolarity leads to decreased vasopressin(ADH) released, this means more H2O released to balance osmolarity and bring it up) Plasma volume(decreased volume---> ADH release to correct)
What is the relative difference in Na+ concentration in the ICF vs ECF?
ECF=higher [Na+] ICF=lower [Na+]
which is higher ESV or EDV? what is the SV
EDV=135 ESV=65 SV=volume ejected=EDV-ESV
peripheral chemoreceptors will have an _______ response to HIGH paCO2 levels when there is hypoexemia too
ENHANCED RESPONSE to PaCO2 with hypoexemia
what is the salt receptor
ENaC
where is the integrating center in the ES? What about the NS
ES=in the endocrine gland NS=spinal cord or brain
what muscles does ventral respiratory group-nucleus ambiguus and nucleus retroambiguus control
EXPIRATORY MUSCLES ABDOMINALS AND INTERNAL INTERCOSTALS ALSO ACCESSORY INSPIRATORY MUSCLES
how is Cl- reabsorped in the early PT (PCT) vs the late PT
Early PT=paracellulary, passive down the electrochemical gradient and solvent drag Late PT=transcellular, apical secondary active formate Cl- antiporter and basolateral facilitated diffusion AND paracellularly
give all sections of the renal tubules starting from Bowmans
Early proximal tubule (early PT or PCT) Late proximal tubule (late PT or PST) Thin descending Limb of Loop of Henle Thin Ascending Limb of Loop of Henle Thick Ascending Limb of Loop of Henle Early Distal Tubule (Early DT) Late Distal Tubule and Cortical Collecting Duct (late DT and CCD) Medullary Collecting Duct(MCD)
What is the Nerst equation?
Eion (mV) = 61/Z log ([ion]ECF / [ion]ICF) Z=valence
provide an example of glomerulotubular balance
Example: GFR increase-GT balance increases PT Na+/H20 reabsorption to maintain Na+/H20 balance
provide an example of Tubuloglomerular feedback
Example: GFR increase-increased NaCl to macula densa- TGF response decreases GFR
what are the channels that create AR pacemaker potential
F type channels=voltage gated Na+ channel Ca2+ (T)=transient voltage gated Ca++ channel
describe APs in Autorhymmic cells of the heart
F-type Na+ channels open and allow some sodium in transient Ca2+ channels are open (keeps membrane at/near threshold vm) when threshold is reached F-type Na+ channels close and L-type Ca2+ channels open to depolarize then K+ channels open which allows the cell to repolarize and the F-type Na+ channels reopen
what are the channels of pacemaker potential
F-type channels=V-gated Na+ channel Ca2+ T=transient voltage gated Ca++
what helps drive fat digestion(breakdown of TG into fatty acids and monoglycerides) by pancreatic lipase and colipase forward
FA and MG are solubilized into micelles in the lumen this removes the products from fat globules so that fat digestion can continue micelles also transport TG digestion products to the brush border membrane
what are the facilitated diffusion rate equations?
FDRions=(deltaG)(T)(# of channels)(Popen) where P=1 for open channels and P=0 for closed FDRmolecules=(deltaG)(
at what lung volume is there lowest total resistance in pulmonary circulation
FRC-functional residual capacity, amount of air left in lungs after a normal TV expiration
functional residual capacity=
FRC=ERV + RV amount thats in the lungs after a tidal volume
what region of Immunoglobulin can bind the antigen. what region is constant
Fab Region=antigen binding area-variable Fc rgeion=constant
what provides taste sensory innervation to the papillae on the soft palate?
Facial nerve's greater petrosal superficial nerve
prothrombin activator
Factor Xa/Va complex formed by both the extrinsic and intrinsic pathways
describe TSH levels and T3/T4 levels in a patient with graves?
Low TSH (due to negative feedback) HIGH T3/T4
why does pulmonary blood pressure not increase substantially during exercise (increased CO)
Lowered TPR through: opening of new capillary beds and distensible arteries
which muscarninc receptors both use Gq prots and act to increase IP3 signaling and have a DAG cascade
M1 and M3
M1: M2: M3: M4: M5: give functions bitchhh
M1: stomach secretions M2: smooth muscles, myocardium, cardiac autorhythmic cells, CNS M3: exocrine glands, smooth muscle, endothelium, CNS M4: CNS, vagal nerve M5: sweat glands (SYMPATHETIC FUNCTION)
what receptor is involved with keeping the predominant HR low, what receptor sets the prodominant tone for the lungs and constricts bronchial smooth muscle?
M2-HR control M3-lung control, bronchoconstriction
what are the receptors involved with parietal cell stimulation
M3 receptor (Ach binding)--->Ca++--->H+/K+ ATPase insertion H2 receptor(histamine binding)--->cAMP---->H+/K+ ATPase insertion CCK2 (Gastrin binding)--->Ca++---> H+/K+ insertion
which muscarinic receptor is the only one used by sympathetic system instead of parasympathetic
M5 for sweat glands
what muscarninc receptor is the only one that has a sympathetic function?
M5-sweat glands
testosterone and estrogens are made where?
MADE IN PERIPHERAL TISSUES NOT ADRENAL CORTEX
give three equations for calculating MAP
MAP=CO x TPR MAP=(HR x SV) x TPR MAP=(HR x (EDV-ESV)) x TPR three ways of saying the same trucking thang gurl CO=HRxSV SV=EDV-ESV
what cells have MHC class II receptors? what cells have MHC class I receptors
MHC class II=Antigen presenting cells MHC class I-all cells
what are changes in the ST segment associated with
MI/disruption of coronary blood flow
what is the fasting pattern of the small intestine motility
MMC motilin sweep intestines of undigested material, one every 90 minutes
alveoli in the base of the lungs are more ______ and undergo _________expansion during inspiration
MORE compliant undergo greater expansion
there are more ______ receptor (thermo) than ______ receptors
MORE cool receptors than warm receptors
beta receptors are _______ sensitive to catecholamines than alpha receptors
MORE sensitive to catecholamines (lower concerntrations needed to activate)
Hypothyroidism Oral Manifestations
Macroglossia Dysgeusia-alteration in taste perception Delayed tooth eruption Poor wound healing and increased risk of infection (due to decreased activity of fibroblasts) Increased periodontal disease Salivary gland enlargement
what path does the olfactory tract take when it enters the brain
Medial Olfactory Area (primitive olfactory system) to the hypothalamus and the limbic system Lateral olfactory area to the less old olfactory system (limbic system, hippocampus) newer system orbitofrontale cortex
what are the TWO areas in the brainstem that primarily control respiration
Medullary Respiratory Center (dorsal respiratory group, ventral respiratory group) Pontine Respiratory Group(pneumotaxic center, apneustic center)
what regions of nephron have Urea reabsorption? where is urea SECRETED via facilitated diffusion
Medullary collecting duct-reabsorbtion of urea via facilitated diffusion Proximal tubule (mainly Distal portion of the proximal tubule reabsorbs Cl- and urea) Thin Descending and Thin ascending Limbs of the Loop of henle have urea secretion via facilitated diffusion
which sensory receptors have smaller receptive fields, what kind of adaption does each display?
Meissners corpsucle (Phasic adaption) Merkels cells (Tonic adaption)
what helps localize CONTINOUS pressure and sensing object texture. Has SLOW adaption
Merkels disks
where are the raphe nuclei located? and what NT do they release?
Midbrain-nucleus raphe dorsalis Pons-Nucleus raphe Pontis Medulla oblongata- nucleus raphe magnus (dampens ascending pain)
what enzymes destroy NE in the synaptic cleft
Monoamine oxidase (MAO) Catechol-O-Methyl Transferase (COMT)
there are more _________ receptors than ___________ (thermal) receptors in the orofacial region but studies indicate that we can perceive increments of ________ better than _________
More cool than warm receptors BUT, whole mouth studies indicate that subjects are better able to accurately detect increments of warming rather than cooling
ADH secretion is more sensitive to changes in what? (ECF osmolarity or ECF volume?
More sensitive to isovolemic osmotic increases increases in osmolarity will have a higher ADH secretion response than isotonic volume depletion
Periodontal Mechanoreceptors includes what receptors and what adaption
Mostly complex Ruffini-like receptors; also free nerve endings. Axons are large & myelinated. Adaptation is both slow and fast
what happens in eryhroblastosis fetalis
Mother is Rh- and baby is Rh+ and fetal blood mixing occurs which causes mom to develop antibodies for Rh on second birth(if baby is Rh+), moms Rh antibodies mix in fetal blood and cause hella problems babys are severly jaundiced and anemic liver and spleen enlargement
what factors influence digestion in small intestine
Motility Large surface area Appropriate pH Hydrolytic enzymes for carbohydrates, protein, fat Emulsifying factors Fat
rank these muscle types in terms of twitch duration (fastest to slowest) (smooth, skeletal, cardiac)
Fastest twitch=skeletal Medium (slower than skeletal)=cardiac Slow Af=smooth
which motility pattern of the small intestine occurs every 90 minutes. What hormone stimulates?
Fasting Pattern (Migrating Motility Complex) Motilin
what other things besides fatty acids and monoglycerides are absorbed by the intestinal cells and then repackaged and sent into the lymphatic system via chylomicrons
Fat-soluble vitamins (A, D, E, K), phospholipids, and cholesterol esters absorbed by same mechanism
what stimulates CCK release?
Fatty acids and amino acids cause CCK-RP release which stimulates I-cells to release CCK
ferrous iron=
Fe2+ the state needed to BIND O2 in Hb
where does final processing of small molecule rapid acting NTs occur.
Final processing occurs in the axon terminal. Vesicles are docked & ready for release from presynaptic terminal
what do taste receptors (not neural, but epithelial cells) synapse with?
First order neurons with redundant bilateral innervation CNX, CNVII, IX
what is the amount of air left in the lungs after a tidal volume
Functional residual capacity FRC=ERV + RV
what is the equation for Filtered load. and what do you need to know to figure it out if given a concentration in mg/dl
Fx=GFR x [X]plasma (Multipication) where X plasma=the concentration of substance in plasma need to know that 125 ml/min is normal GFR need to know that 1dl=0.1L or 1dl=100 ml
what is zollinger ellision syndrome?
G cell tumor--->increased gastrin-->increased stimulation of ECL and parietal cells --->increased HCl release ---->ulcers
what G-prot is used for sweet, bitter and unami taste receptors (TR1 and TR2)
G-prot gustducin
what type of receptor does ADH bind to?
G-prot receptors in late DT and CD activates cAMP which increases synthesis and insertion of AQP-2 into the luminal membrane
what do hypothalamic hormones bind to in the anterior pit?
G-protein coupled receptors
decribe the signaling that occurs in olfactory receptor cells
G-protein coupled receptors coupled to adenylyl cyclase increased levels of cAMP open sodium channels to depolarize the olfactory neuron
all of the hypothalamic releasing and inhibiting hormones act on what type of receptors?
G-protein coupled receptors in the anterior pituitary
what can cause ferric state (Fe3+) hemoglobin (methemoglobin)
G6PDH deficiency or exposure to some local anesthetics(prilocaine and benocaine
what type of neurons are lost in Huntingtons disease?
GABAergic neurons resulting in reduced inhibitory output from striatum
what are the layers of the adrenal cortex
GFR Zona Glomerulosa-mineralcorticoids(~15%), Zona Fasciculata(glucocorticoids) (~75%), Zona Reticularis (androgens)(~10%).
what is the filtration fraction equation
GFR/RPF RPF=renal plasma flow
Tubular (Filtered) Load=
GFRx[substance]plasma
List all hormones produced by the anterior pit (6 of them)
GH ACTH=adrenocorticotropin Thyroid-Stimulating Hormone Follicle Stimulating Hormone Luteinizing Hormone Prolactin
what two hormones stimulate chondrogenesis and widening of the epiphyseal plates followed by bone matrix deposition to stimulate linear growth
GH and IGF-1 these hormones also play a role in bone turnover
What causes Solitary median maxillary central incisor? What sex is it more common in ?
GH deficiency present in both primary and permanent dentition MORE common in females
what are the two inhibitory hormones released into the median eminence
GHIH=somatostatin PIH=prolactin inhbiting hormone
what (chemicals) will stimulate GH release
GHRH Dopamine Catecholamines Excitatory amino acids Thyroid hormone
what things can stimulate G-cells to produce gastrin?
Gastric Phase-distension activates ENS (Ach) stims G-cells Peptides in stomach directly stimulate G-cells Distension directly stimulates G-cells
what is Wernickes area
General interpretive area where somatic, visual and auditory association areas all meet
What is the cellular mechanism of the M2 receptor. where are they located
Gi prot decreased cAMP and activation of K+ channels heart, some nerve endings
Lentiform Nucleus =
Globus Pallidus + Putamen Corpus
what is primary control point for GFR (think of starling forces)
Glomerular Pg hydrostatic pressure determinant of GFR most subject to physiological control
give a mechanistic explanation for increased sodium reabsorption in the renal tubules with elevated proteins and with glucose
Glucose reabsorption on the apical side requires an SGLT secondary active transporter that moves both glucose and Na+ into the cell amino acids require a similar transporters that uses Na+ gradient to also bring in amino acids
what is the cellular mechansim of M1 receptor. where they be located
Gq coupled prot Increased IP3 signaling and DAG cascades nerve endings
What is the cellular mechanism of the M3 receptor. where are they located
Gq prot increased IP3 and DAG cascade
what are the mechanisms of action of GH and IGF-1
Growth in nearly all tissues in the body (MAINLY via IGF-1) Amino-acid uptake and prot synthesis (lean body mass) Reduced glucose utilization- decreased uptake and increased hepatic glucose production (insulin resistance) Mobilization of fatty acids from adipose tissue (increased FFA in blood) decreased adiposity
all beta receptors use what cellular signaling mechanism? (which G prot?) How does this compare to alpha 1 and 2
Gs protein AND increased cAMP Alpha 1 uses increased IP3 signaling and DAG Alpha 2 decreases cAMP signaling
what are two demyelination diseases we discussed
Guillan-Barre Syndrome
what is the most important chemical factor that controls breathing and why
H+ (anything below 7.4 pH) and its most important because its detected by central chemoreceptors in the ventral surface of the medulla
chemoreceptors in the CSF are only sensitive to changes in __________
H+ concentration in the CSF!!! via PaCO2 conversion into H+ by carbonic annhydrase
describe H+, HCO3- and CO2 concentrations in respiratory acidosis?
H+ increase HCO3- increase (from renal compensation of excreting H+) CO2 increase (primary abnormality)
what allows for 95% of filtered bicarb (HCO3-) to be reabsorbed and requires 4000 mEq of H+ to be secreted
H+ secretion by secondary active transport in proximal tubule, TAL, and early distal tubule Na+/H+ antiporter on the apical membrane secretes H+ into lumen which combines with HCO3- to form H2CO3 which dissosiates into CO2 and H2O---> CO2 enters cell and combines with water in the presence of carbonic anhydrase which then allows for HCO3- and H+ formation HCO3- moves into the interstitial fluid via a Na+/HCO3- symportor (bicarbonate provides gradient for Na+ to be actively transported out)
what transporters are used in parietal cell acid secretion on the apical side
H+/K+ ATPase on apical also channels for K+(out of cell) and Cl-(out of cell)
95% of filtered HCO3- is reabsorbed by what processes and where does it occur?
H+/Na+ secondary active transportor on apical side of membranes in proximal tubule, TAL, early DT conserves HCO3- and secretes H+ H+ combines with HCO3- in filtrate and gets converted to H2CO3--->CO2 and H2O CO2 diffuses in and becomes HCO3- and H+ HCO3 conserved moved into interstitial fluid while H+ secreted into lumen
at body temperature H2O moves ________ than glucose at constant body temp. Why does this happen (mechanistic explanation)
H20 moves really freaking fast compared to glucose think about rate of movement equation alpha(T)/(M) H20 has much lower mass and with constant temp it will have a higher rate of movement
what is the largest transport mechanism for CO2 in the body 70% of CO2
HCO3- bicarbonate
what processes require H+ secretion by the tubular epithelium? 4 things
HCO3- reabsorption addition of new HCO3- to ECF Acid excretion rate of secretion must be controlled to maintain acid base balance
what solutes have a higher absorption rate than H2O absorption rate in the PROXIMAL tubule
HCO3-, Glucose, Amino acids
what transporter of parietal cells are involved in the alkaline tide after a meal
HCO3-/Cl- secondary active antiporter (HCO3- provides energy for Cl- transport into the cell) Cl- moves against gradient and HCO3- moves down its gradient
match the following with the cell type they belong to (Type A intercalated, Type B intercalated) HCO3-/Cl- transporter on apical HCO3-/Cl- transporter on basolateral Cl- transporter on apical Cl- transporter on basolateral H+ ATPase apical H+ ATPase basolateral H+/K+ ATPase apical H+/K+ ATPase basolateral
HCO3-/Cl- transporter on apical=Type B HCO3-/Cl- transporter on basolateral=Type A Cl- transporter on apical =Type A Cl- transporter on basolateral=Type B H+ ATPase apical=Type A H+ ATPase basolateral =Type B H+/K+ ATPase apical=Type A H+/K+ ATPase basolateral=Type B
what is the difference between HCl secretion and intrinsic factor secretion from oxyntic (parietal) cells
HCl is accomplished through H+/K+ ATPase, Cl- transporter Intrinsic factor is a glycoprotein released via exocytosis
secondary hyperaldosteronism would have _____ renin levels
HIGH renin levels
more positive charge means what for filterability?
HIGHER filterability
proximal tubule is ________ permeable to h20
HIGHLY permeable to H20
what is the zona reticularis controlled by?
HPA (hypothalamic pituitary)
which sensory receptors are rapidly adapting?
Hair end organs Meissners Pacinian
the O2 that is reversibly bound to hemoglob inside RBC DOES NOT CONTRIBUTE to what?
Hb bound O2 DOESNT contribute to partial pressure PaO2
the predominant tone for the heart is set by __________ and the predominant tone for the lungs is set by _________
Heart M2 receptors (PNS) Lung M3 receptors (PNS)
what are the permeable compounds to a PURE phospholipid bilayer (not a cell plasma membrane)
Hydrophobic substances-small non polar molecules Ex. gases, fatty acids, steroids lipophilic substances (ethanol) water (only exception to non polar rule)
what are the filtration Starling Forces governing bulk flow
Hydrostatic Pressure of the Capillary-30mmHg on Arterial end , 10mmHg on venous end Colloid Osmotic pressure of the Interstitial Fluid-8mmHg
what happers in primary hyperparathyroidism
Hypercalcemia leads to polyuria and calcuria Low phosphate due to increased renal excretion Muscle weakness and easy fatigability Osteoblastic activity also increased leading to high secretion of alkaline phosphatase (ALP). Extreme osteoclastic activity in bones causes cystic bone disease (osteitis fibrosa cystica)
what can causes GH deficiency?
Hypothalamic Disorders Mutations of GHRH receptors, GH gene, GH receptor, IGF-1 receptor Combined pituitary Hormone deficiencies (panhypoputuitariusm) Radiation Pyschosocial deprivation
what carries the hypothalamic hormones to the sinuses of the anterior pituitary
Hypothalamic=Hypophyseal Portal Vessels
what are the three types of Diabetes Insipidus
Hypothalmic or Central- defect in ADH synthesis or release Nephrogenic DI- defect in ADH action; failure to maintain hyperosmotic medullary gradient Polydipsic DI- compulsive water drinking
light band corresponds with what?
I band (part of sacromere with the thin filaments)
what is the light band of skeletal muscle
I-band
what sensory nerves have the fastest response times and the most wide diameter axons
IA and IB Muscle Spindles (Primary ending) Muscle Tendons involved in proprioception
what is pH of the following? ICF ECF
ICF pH=7.0 (slightly more acidic) ECF pH=7.4 (slightly less acidic)
what are somatomedins?
IGF-insulin like growth factors
what is the cold-menthol receptor type I (CRM1/TRPM8)
IN ORAL CAVITY menthol and related compound will bind and decrease the threshold of the channels so that warmer compounds are percieved as cold
+ ionotropic agents will ______ ejection fraction
INCREASE through increased contractility
Syndrome of Inappropriate ADH would do what to plasma and urine osmolarity
INCREASED ADH plasma osmolarity- hypoatremia, hypoosmotic Urine osmolarity-hyperosmotic urine
during the gastric phase distension does what to G-cells
INDIRECTLY stimulates G-cells via ENS release of ACh onto M3 receptors DIRECTLY stimulates via peptides from food
which medullary respiratory center contains opiate receptors and what do they do when activated
INHIBIT respiration and DECREASE sensitivity to changes in PCO2
what is the cellular mechanism of Muscarnic receptors
IP3 signaling Increased intracellular Ca++
what does the Fc heavy chain determine?
Ig classification
what immunoglobin is the MOST potent activator of the complement and largest of the immunoglobins
Ig<
what Ig provides mucosal and neonatal immunity (via breast milk)
IgA
which Ig is the secretory Ig
IgA
which immunoglobin is a receptor on B lymphocytes that aids in antigen recogntion by B lymphocytes
IgD
which antibody activates basophils, mast cells and eosinophils
IgE
which antibody type mediates type 1 hypersensitiy reactions defends against parasitic infecitons and activates basophils, mast cells and eosinophils
IgE
what is type I hypersensitivy
IgE mediated immediate anaphylactic IgE induced by allergen, binds to mast cells and basophils. on succeeding exposures allergen cross links bound IgE and induces degranulation of mast cells and basophils
what are the primary antibodies in the secondary response
IgG
what is the primary antibody in the secondary response
IgG
what is the most abundant immunoglobin in blood? what about the most abundant in the whole body
IgG=most abundant in blood IgA=most abundant in body
which antibody is THE MOST POTENT ACTIVATOR OF THE COMPLEMENT
IgM
what is the Largest Ig
IgM MOST POTENT ACTIVATOR OF THE COMPLEMENT TOO
what is the Ig produced in the first response? what is the Ig produced in the second response
IgM-first response IgG-second response
what happens in the early distal tubule
Impermeable to H20 and Urea Reabsorbs ions (5% of Na+ and Cl-)=dilutes filtrate (diluting segment) Na+-Cl- co transporter in apical membrane moves Na+ and Cl- into cells from tubule lumen Na+/ ATPase transports Na+ into the interstitium Cl- diffuses into the interstitium through channels in the basolateral membrane
in the ammonia buffer system what is the difference in mechanism for H+ and HCO3- between the PT, TAL and DT vs the collecting duct
In PT, TAL and DT, NH4+ is added to filtrate following glutamine metabolism and represents acid secretion In CD, NH3 is secreted into the lumen where it combines with H+ to form NH4+ BOTH result in NEW HCO3- being added to the ECF
what is the equation for transmural or transpulmonary pressure
Palv - Pip
Transmural pressure=
Palv-Pip alveolar presure minus intrapleural pressure
what enzymes assist with fat digestion in the small intestine, what end products are produced
Pancreatic lipase and colipase produces fatty acid x2 and monoglyceride
in the ureters and bladder what do the following do? Parasymphatetics- Pudendal nerve- Sympathetics-
Parasympathetics-enhance ureter peristalsis, stimulate contraction of detrusor and relaxation of internal sphincter Pudendal nerve-somatic motor neurons for external sphincter Sympathetics-decrease peristalsis of ureters and control bladder blood vessels
what are the secretions of the following fundus(oxyntic gland) gastric cells? Parietal (oxyntic cell) Chief cell Surface mucous cell ECL cell D Cell
Parietal (oxyntic cell)-HCl and Intrinsic Factor Chief cell- Pepsinogen Surface mucous cell-Mucus, HCO3-, Trefoil factors ECL cell-Histamine(paracrine) D Cell-somatostatin
what moves iodide across the apical membrane into the colloid?
Pendrin (Cl-/I-) exchanger
what are the structures inside Pons
Penumotaxic center(regulates breathing, activation limites insipration time and inceases respiration rtae) Nuclei of the Reticular formation Pontine Recticular and vesibular nuclei for motor control Swallowing Center (along with the Medulla Oblongata).
what are some oral manifestations of DM
Periodontal Disease Salivary and taste dysfunction Oral bacterial and fungal infections (ex. candidiasis) Oral mucosa lesions (geographic tongue, lichen planus, etc.) Diminished salivary flow and burning mouth syndrome (with poor glycemic control) Delayed mucosal wound healing Xerostomia in patients on oral hypoglycemic agents
what do macrophages and neutrophils do to recognize to determine to phagocytose
Phagocytes contain Toll-Like Receptors (TLRs) that are capable of recognizing generic Pathogen-Associated Molecular Patterns (PAMPs) and Damage-Associated Molecular Patterns (DAMPs) Rough surface Native substances should have protein coats that repel phagocytes If a target has an immunoglobulin/antibody attached to it, then it is marked for phagocytosis (opsonization)
what are the phases of contractile cell APs
Phase 4- resting Vm Phaso 0- depolarization spike, fast v-gated Na+ channel (activation/inactivation gates) opens Phase 1- partial repolarization, fast v-gated na+ channel closes Phase 2- Plateu, transient K+ channels close, L-type Ca++ channels open Phase 3- repolarization, L-type Ca++ channels close , slow K+ channels open
what is the normal net reabsorption pressure in the peritubular capillaries and what creates it
Pif=6mmHg, reabsorbtive Pc=13mmHg, filterative colloid pressure of capillaries 32 mmHg, reabsorptive force colloid pressure of intersitial fluid is 15mmHg 6+32=38 reabsorptive force 15+13=28 mmHg filterative force 38-28=10 mmHg
pneumothorax would mean that Pip= Ptp=
Pip=Patm thus Ptp will be 0 and there is no pressure to hold lung open
what are the different types of diagnostic tests for endocrine function
Plasma hormone levels Autoantibodies: Hashimoto thyroiditis, type I diabetes, Graves disease, Addison disease, autoimmune hypoparathyroidism Urine hormone or hormone metabolite levels Stimulation tests by administration of a trophic or stimulating hormone (ex. ACTH to stimulate cortisol release, glucose load to stimulate insulin release) Suppression tests when hyperfunction of an endocrine organ is suspected (ex. response of GH to a glucose load or dexamethasone a synthetic glucocorticoid to suppress ACTH and Cortisol) Measurement of hormone receptor presence, number and affinity (ex. estrogen receptors in breast tumors) Imaging: Radioactive scanning of the thyroid and parathyroids; MRI of pituitary and hypothalamic imagine, CT scanning of adrenal and abdominal endocrine lesions, etc.
what is plasmin
Plasmin is activated a few days after a clot forms and helps with fibrinolysis by digesting fibrin fibers, fibrinogen, prombrin and factors V,VIII,XIII
what does the reticulospinal descending pathway include?
Pontine Reticular Nuclei-transmit excitatory signals in the retriculospinal tract Medullary Reticular Nuclei-transmits inhibitory singals via tracto
what are the transporters used on the apical side of an alpha intercalated cell in the late distal and collecting duct tubules to secrete H+
Primary Active H+ transporter (can pump against a huge gradient) Cl- channel primary active antiporter H+/K+ ATPase
what is Conns Syndrome (is it primary or secondary)
Primary hyperaldosteronism from adrenal adenoma, adrenal hyperplasia, adrenal carcinoma
which cells secrete K+ with high K+ intake which cells reabsorb K+ with low K+ intake
Principal cells secrete K+ alpha intercalated cells reabsorb
what do colon bacteria produce?
Produce vitamin K ferment undigested carbs into short chain fatty acids which are absorbed they also produce methane gas increase the resistance of the intestinal mucosa to colonization with pathogenic organisms
Where do ventral tegemenal area neurons project to and what do they release? dysfunctions of this can cause what?
Project to the Nucleus Accumbens and the prefrontal cortex they release dopamine dysfunction of this is associated with addiction, schizophrenia and phychoses and learning deficits
why is it that a small amount of aterial occlusion can have a huge impact on flowrate at a constant pressure
Q=deltaP/R where R=8nl/(pi x r^4) decreases to radius of a vessel exponentially increases R(resistance) which will cause huge decreases to Q which require huge pressure changes to restore the original Q
what ECG wave shows ventricular depolarization and atrial repolarization
QRS complex
local flow(tissue) formula=
Qtissue=MAP/Rarterioles
how do ordorants effect olfactory receptor cell membrane potentials
RMP of olfactory cells is -55 mV so they continously fire but ordants cause depolarization to -30 mV which increases AP frequency The rate of APs varies logarithmically in proportion to stimulus strength
what (chemicals) will inhibit GH release
Somatostatin IGF-1 Glucose FFA
how do pain and temperature signals ascend the spinal cord?
Spinothalamic/Anterolateral Pathway signal crosses over to the other side immediately at the second order neuron and ascends in either the anterior or lateral spinothalamic tract on the opposite side of the spinal cord from where the stimulus occured
what is reynolds number equation
Re=(Vxdxp)/n V=velocity of blood flow d=diameter of vessel p=dentistry of blood n=viscosity of blood=hematocrit
what is reabsorbed in the PCT? what is secreted
Reabsorbed-65% of filtered Na+, Cl-, HCO3- and K+ AND All filtered glucose and amino acids Secreted- metabolic waste products(H+, organic acids, bases like bile salts, oxalate, urate and catecholamines), harmful drugs or toxins, Para-aminohippuric acid
Spinocerebellum(vermis)-
Receives sensory input from proprioceptors and coordinates movements distal limbs (hands, fingers)
what are causes of hyperkalemia
Renal failure Decreased distal nephron flow (heart failure, severe volume depletion, NSAID, etc.) Decreased aldosterone or decreased effect of aldosterone - adrenal insufficiency - resistance to aldosterone - K+ sparing diuretics (spironolactone) Metabolic acidosis (hyperkalemia is mild) Diabetes (kidney disease, acidosis, insulin)
what are signs and symptoms of primary hyperparathyroidism
Renal stones polyuria, polydipsia, uremia osteomalacia hypercalcemia-polyuria and calcuria low phosphate levels (increased renal excretion) muscle weakness osteoblast activity increase constipation indigestion vomitting
what are examples of autoimmune disease
Rheumatic Fever Myasthenia Gravis Systemic Lupus Erythematosus Rheumatoid Arthritis Sjogren's Syndrome Multiple Sclerosis Type I Diabetes Graves' Disease
what will cause a right shift to the oxyhemoglobin curve
Right shift=more unloading of O2 and less loading increased CO2 increased Temperature Increased 2,3 bpg increased H+, more acidic environments
what sensory receptor has the LARGEST receptive fields? ie. worst acuity
Ruffini Endings
what nerves are sensitive to stretch or indentation; proprioception?slow or phast adaption?
Ruffinis endings slow(tonic)
heart conduction pathway
SA node internodal pathways AV node-delay of 0.1 sec bundle of His(AV bundle) down bundle branches up purkinje fibers purkinje fibers also supply papillary muscle; these contract during ventricular contraction to tighten chordae tendineae and prevent AV valve from prolapsing into the artia
what is the simple diffusion rate equation?
SDR-alpha(deltaG)(T)(A)/(RxD) deltaG=gradient T=temp A=surface area R=resistance(viscosity of fluid, size) D=Diffusion distance
Describe the locations of the following transport proteins (apical or basolateral and Early-middle PT or middle-late PT) SGLT1 SGLT2 GLUT2 GLUT1
SGLT2=Apical side, early to middle PT, Low affinity, high cap SLGT1=Apical side, middle to late PT, high affintiy, low cap GLUT1=basolateral side, middle to late PT, high affinity, low capacitiy GLUT2=basolateral side, early to middle PT, low affinity, high capacity
90% of glucose is absorbed in the PCT using what two transporters? Which sides are they located on and what part of PCT. What affinity and what capicity?
SGLT2=apical side(lumenal), early-middle PCT GLUT2=basolateral(blood), early-middle PCT both are low affinity BUT high capacity
the pacemaker cells of smooth muscle have _______ depolarization to threshold and are found in
SLOW depolarization found in GI tract
are warm and cold receptors faster or slower than deep pressure and touch receptors?
SLOWER cold receptors are faster than warm but still slow
which motor units have the LOWEST threshold for firing. When are they recruited?
SMALL MOTOR (slow twitch oxidative Type 1 fibers) HAVE LOW threshold THEY ARE RECRUITED FIRST
what controls the smooth muscle in veins and what is the function
SNS controls venoconstriction will promote venous return through increasing the venous pressure
What does the sympathetic nervous system act on to increases HR? how does the parasympathetic nervous system decrease HR. This will show up on exam for sure
SNS=increases HR through action on AR and CONTRACTILE cells) PNS decreases HR through action ONLY ON AR cells NOT on contractile
where does the Ca++ for contaction of smooth muscle come from
SR Extracellular Ca++ entering cell through plasma membrane Ca2+ channels
pulse pressure is a function of
SV/C stroke volume
ejection fraction equations
SV/EDV (EDV-ESV)/EDV fraction of EDV that is ejected in each beat
what receptors are used on ductal cells for stimuli of secretion of H2o and HCO3-
Secretin receptor M3 (Ach receptor
which olfactory pathway provides conscious perception and anaylsis of olfaction
Segment of the lateral olfactory system newer system-to the orbitofrontale cortex
ST elevation would indicate?
Myocardial infraction-loss of cornary blood flow
what is the only inhaled anesthetics that does cause respirtory depression via a decreaed response to low O2 and high CO2? actually causes an increase in respiratory rate
N2O nitrous oxide
what would inhalation of N2O do to V/Q ratio? what would inhalation of NO do to V/Q ratio?
N2O would increase V/Q by increasing vascular resistance and decreasing perfusion (minimal changes to Ventilation) (Lower Q) NO would decrease V/Q by decreasing vascular resistance and increases perfusion (higher Q)
what local and systemic controls will increase afferent AND efferent arteriole resistance and decrease GFR
NE and epi (sympathetics) Endothelin
give a mechanistic explanation for sympathetics increasing HEART RATE
NE binding to B1 receptors causes increased permeability in t F type Na+ channels and increased permeability of Ca++ transient channels, this increases the membrane potential and makes them more excitable less time to threshold and increased heart rate
what are the sympathetic mechanisms to increase HR. What receptors and what happens to threshold time
NE/B1 adrenergic Increased presence of F-type Na+ channels and Ca++ (transient) channels decreases time to threshold increases HR
what do nearly all sympathetic postganglionic terminal release at synapse with target cells
NE/noradrenaline which activate alpha and beta receptors
describe the mechanism of the ammonia buffer system in the PT, TAL and DT with excess H+(up to 500 mEq/day) being buffered and secreted
NH4+ is added to the filtrate following glutamine metabolism into 2HCO3- and 2NH4+ glutamine enters the cell from both the interstitial and filtrate 2HCO3- exits the cell on the basolateral side into the interstitial fluid as new HCO3- 2NH4+ exits the cell on the apical side via a NH4+/Na+ antiporter and combines with Cl- ultimately results in new HCO3- being added to the ECF responsible for 50% of the acid excreted and 50% of the new HCO3-
describe NH4+, H2PO4- and HCO3- concentrations and locations in filtrate and ECF with a patient undergoing acidosis
NH4+, H2PO4- are generated in filtrate almost all of the filtered HCO3- is reabsorbed New HCO3- is added to the ECF
describe thyroid hormone synthesis
NIS symporter moves iodide along with Na+ into the intracellular environment Pendrin (Cl-/I- exchanger) moves iodide into the colloid and Thyrogoblulin precursor moves into the colloid as well Peroxidase iodinates the thyrogobulin and then it is transported back into the follicular cell via pinocytosis inside the cell proteases cleave the precursor into T4 and T3 (as well as MIT and DIT) which is then secreted out
is recruitment of muscles a synchronous process?
NO IT IS ASCYNCHRONOUS
are central chemoreceptors activated by ARTERIAL H+? Explain this
NO THEY ARE NOT they are activated by PaCO2 CO2 can cross blood brain barrier where it is then converted into H+ IN THE CSF by carbonic anhydrase this is what stimulates central chemoreceptors to simulate DRG
do smooth muscle cells have synapses with autonomic motor neurons?
NO THEY DONT they use varicosities instead to release NTs that will either stimulate or inhibit the muscle
is velocity=flow
NO different but related things V=Q/A Q=DeltaP/R where R=8nl/(pi x r^4)
in respirtory tract what is the difference between NO and N2O
NO is a potent vasodilator N2O is a mild symphathomimetic, increases pulmonary vascular resistance via decreased perfusion (vasoconstriction)
is the ventral respiratory group active during normal breathing?
NO its only involved when forceful expiration is required
olfactor receptor proteins are ______ dedicated to single odorants
NOT dedicated to a single odorant
what will increased MAP do to Pc?
NOTHING YA STUPIDDD BITCCHCHHHH because myogenic autoregulation prevents changes in MAP affecting blood flow to capillaries
what part of the medulla receives taste sensory information
NTS-nucleus tractus solitarii
where are the second order neurons for taste reception located
NTS=nucleus tractus solitarii in the medulla THIS IS PURELY SENSORY
what is the main contributor to ECF molecularity
Na+
what are the impermeable solutes?
Na+ K+ Cl- HCO3 Proteins urea(non systemically, single cell) Glucose(non systemically, single cells and other shitt
name every solute that is reabsorbed by the thick ascending limb, what is secreted?
Na+, K+, Cl-, Ca++, HCO3- and Mg++ H+ is secreted
what are the two transporters of protein digestive end products on the apical surface of small intestine cells
Na+/Amino Acid(secondary active symporter) H+/Small peptide transporter=PEPT1
what controls the rate of K+ secretion by principal cells
Na+/K+ ATPase activity transepithelial potential difference between blood and lumen permeability of apical membrane for K+ (BK and ROMK channels)
what three factors determine rate of K+ secretion by principal cells
Na+/K+ ATPase activity in basolateral membrane transepithelial potential difference on apical (more negative=better secretion of K+) permeability of apical membrane (BK, ROMK channels)
what transporters are required for H+ secretion into the tubular lumen (apical side)
Na+/K+ATPase on basolateral side pumps sodium out of cell and brings K+ in NHE transporter on apical side brings Na+ in and H+ out
what are all the mechisms of capillary exchange
Narrow water filled spaces-intercellular spaces (no tight junctions) Movement of fluid and dissolved substances via Bulk Flow (ΔP) Vesicle fuse to form water filled channel Movement of fluid and dissolved substances via Bulk Flow (ΔP) Transcytosis and Transepithelial Transport Simple Diffusion
nervous system physiological effects of thyroid hormone?
Needed for normal development of the NS Impacts reflex time (i.e. hypothyroidism can cause prolonged reflex times) Muscle tremors due to increased reactivity of neuronal synapses Feeling of tiredness but difficulty sleeping Anxiety, worry and paranoia
where are alpha 2 receptors located and what is the major function
Nerve endings, SOME smooth muscle decreased NT release from nerves contraction in muscle
What are the two types of Diabetes Insipidus? What symptoms?
Neurogenic/central-brain doesnt produce ADH Nephrogenic/peripheral-kidney wont respond to ADH both lead to increased thirst and loss of water (polyuria)
what are the carrier proteins for the posterior pit hormones
Neurophysin I-oxytocin Neuronphysin II- for ADH
if you ingest NaCl only what will this do to ECF volume/osmolarity. What responses will the body have
No change in ECF volume INCREASE in ECF osmolarity which stimulates.... 1. ADH vasopressin) release- conservation of water in kidneys by reabsoprtion which increases ECF volume 2. Thirst-increases ECF volume and BP while the kidneys slowly work to excrete salt and water while the cardiovascular system lowers the BP
is the late distal/cortical collecting duct permeable to urea?
No it is impermeable to UREA
can simple diffusion be regulated?
No regulation Does not require a plasma membrane
would multiunit smooth muscle have tone?
No ya stupid face only single unit will have this
what two centers in the medulla oblongata act to inhibit ascending pain signals. What NT does each of them use? What midbrain structure activates them
Nucleus Raphe Magnus(serotonin) Rostral Ventromedial Medulla(norepinephrine)
what is the universal donor type?
O negative
what are the vasoconstricting paracrines
O2 Endothelin Thromboxanes
what is the rate of the fluctuation in the metarteriole and precapillary sphincters controlled primarily by?
O2 levels in tissue low O2, SM spends more time in relaxed state and blood takes convoluted path through capillary bed high O2 SM spends more time in contracted state and blood takes most direct path through capillary bed
O2 consumption reflects _______ will ATP consumption reflects _______ in the kidney
O2 reflects ATP consumption ATP consumption reflects active transport
where is the only part of the nephron were filtered Glucose and amino acids can be transported
ONLY IN THE PCT
where is the Na+/2Cl-/K+ transporter only found in the tubules?
ONLY IN THE thick ascending limb
what will angiotensin II do to renal arterioles and what is the effect on RBF and GFR
ONLY INCREASES EFFERENT ARTERIOLE RESISTANCE, no affect on afferent Decreases RBF but INCREASES GFR
what is optimal length and what does it mean in terms of tension produced
OPTIMAL LENGTH is where there is the best degree of overlap between the thick and thin filaments AT OPTIMAL LENGTH THERE IS MAXIMAL TENSION Production
what are the three principles of coding of olfaction
Olfactory receptor proteins are NOT dedicated to single odorants Different olfactory receptor proteins respond differently to the same odorants (odorants can cause different responses at different receptors) Across-Fiber Pattern Code (not a labeled line)
what are the stimuli for ADH secretion and what specifically does it do?
Stimuli=Increased ECF osmalarity, decreased MAP increases H2O premeability in the late DT and CD via mediated increase in synthesis and insertion of AQP-2 into the luminal membrane
rank twitch duration times of skeletal, cardiac, smooth muscl
Skeletal=fastest cardiac smooth=slowest
where does the MAJORITY of fat digestion happen?
Small intestine
describe enzymes involved in luminal small intestine protein digestion?
Small peptides and amino acids are produced by lumen Tyrpsin Chymotrypsin Carboxypolypeptidase Elastase
what are the two fast twitch fibers
Oxidative-Glycolytic-Type IIA Glycolytic- Type IIB
what is boyles lay
P1V1=P2V2 changes in volume or pressure will allow for flow of air
Periaqueductal Gray Region is in the ______ and activates neurons in the _________ which do what?
PAG is in the midbrain and is part of a descending pathway that modulates pain transmission through inhibition of dorsal neurons PAG neurons activate neurons in the nucleus raphe magnus and rostral ventromedial medulla that project to the spinal cord and release serotonin and norephinerine and inhibit sensory neurons from nociceptive afferent fibers
phagocytes contain Toll like receptors that are capable of recognizings __________
PAMPS (pathogen associated molecular patterns) and DAMPs(damage associated molecular paterns
A drop in CSF pH is reflextive of ONLY a higher than normal amount of ___________
PCO2 carbonic anhydrase converts H2O and CO2 into H+ this is detected by central chemoreceptors in the CSF
why is the PEPT1 transporter so interesting? Describe it and its location
PEPT1 transport can transport multiple kinds of small peptides produced in protein digestion and it is not specific to any types It works as a secondary Active symporter (H+ and small peptides brought in)
what hormones and paracrines will work to decrease Ra (resistance of afferent arteriole)
PGE2, PGI2 bradykinin NO- decreased resistance of BOTH afferent and efferent but still increases RBF and GFR
what is the partial pressure of water vapor in the conducting zone? what does this humidifying do
PH2O=48 mmHg this addition of water decreases the partial pressure of all other gasses
what are the PNS actions in the bladder (what receptors?) what about SNS?
PNS: M relaxes sphincter, M constricts the detrusors SNS: alpha 1 constricts sphincter and beta2 relaxes detrusor
pulse pressure is ______ related to SV and it is ______ related to compliance
PP is directly related to SV and indirectly related to compliance PP=SV/C
what primary controls the feeding pattern of small intestine motility?
PRIMARILY THE ENS interstitial cells of Cajal
A or B antigens can be in the plasma ______
PRIOR TO ANY EXPOSURE appear 2-8 months after birth
bulk flow is the movement of
PROTEIN FREE fluid between plasma and interstitial fluid through WATER FILLED CHANNELS filtration and absorption magnitude and direction of fluid movement is determined by delta P
INR tells you what
PT against a normalized ratio
what does the illeum secretion
PYY and HCO3-
what can increase conversion to zone 1 of the long
Pa drops (hemorrphage) PA increases (positive pressure breathing)
in Zone 1 Pa is _______ than PA
Pa lower than PA capillaries are compressed arterial pressure cannot overcome Alveolar pressure to open capillaries
if someone had CO poisoning what would happen to their PaO2 levels? what about CaO2?
PaO2 levels might be normal! (remember that PaO2 has nothing to do with Hb-O2 binding) CaO2 levels would be greatly reduced!, more CO bound than O2 because it has 250x greater affinity for Hb CaO2- its the combo of PaO2 and O2 bound to hemoglobin
TPR is a function of _______ resistance and NOT
TPR=arterial resistance NOT VEINS
what are the two taste receptor genes for the sweet, bitter and umami tastes. What G-prot do they use?
TR1 and TR2 G protein Gustducin
what is the vanilloid receptor subtype(poly modal) what activates it?
TRPV1 Receptor in ORAL cavity activated by capsaicin, temperature greater than 43 degrees and protons decreases the threshold of channel activation so that heat is perceived at 33 degrees
vital capacity is
TV +ERV + IRV
Inspiratory capacity(IC)=
TV+IRV
thromboxane A will ________ platelet aggregation and activation while NO and prostacyclin (PGI2) will ________
TXA2=stimulates aggregation and activation NO and PGI2= inhibit aggregation and activation
describe adaption of thermoreceptors
They mostly (but never completely) adapt to constant temperature; BUT they quickly change their activity in response to changes in temperature. They are very sensitive to changes in temperature. If the temperature reaches one of the pain thresholds, the sensation becomes more persistent throughout the stimulus
what are the water soluble vitamins that are absorbed in the upper small intestine with cotransport of Na+
Thiamin, riboflavin, niacin, pyridoxine, pantothenate, biotin, and ascorbic acid
what are the oral manifestations of GH excess
Thick rubbery skin, enlarged nose, and thick lips Macrocephaly Macrognathia Disproportionate mandibular growth Mandibular Prognathism Generalized Diastemata Anterior open bite and malocclusion (macrognathia and tooth migration) Macroglossia, Dyspnea, Dysphagia,Dysphonia, Sialorrhea Hypertrophy of the pharyngeal and laryngeal tissues, sleep apnea thickening of the skull (calvarium)
what skull changes can occur in GH excess (acromegaly)
Thickened calvarium Prognathatic mandible Enlarged frontal sinuses and pituitary fossa
what is the main hormone released by the thyroid gland
Thyroxine(T4)
what are the binding proteins for T3 and T4
Thyroxine-binding gobulin Transthyretin Albumin
flow out of systemic arteries=
Total peripheral resistance TPR=the sum of the R in arterioles (vasoconstriction)
Dorsal column-medial lemniscal Pathway transmits what information
Touch, Pressure and Proprioception
Nystagmus:
Tremor of the eyeballs
T/F smooth muscle activation may or MAY NOT have a change in Vm
True it might not need a Vm change to contract.... this is different from skeletal and cardiac
Tubuloglomerular feedback= Glomerulotubular balance=
Tubuloglomerular feedback Afferent and Efferent arteriolar resistance related to flow rate of NaCl by macula densa Keeps GFR constant Glomerulotubular balance PT reabsorption rate related to tubular load (how calculate?) Prevents overloading of distal nephron
Tx= Px=
Tx=[solute] in filtrate Px=[solute] in plasma
what cell types are in the alveoli
Type I cells (simple squamous epithelial type II cells (alveolar-produce surfactant) macrophages
give a mechanistic explanation for why Type I fibers are slower than Type II
Type I has an isoform of myosin with SLOWER ATPase activity while type II have a FAST myosin ATPase
describe the oxidative capacity
Type I-high cap Type IIA-moderate Type IIB- low
describe SR Ca++ ATPase capacity in Type I, IIA, IIB
Type I-slow Type IIA- fast Type IIB- fast
describe myosin ATPase activity in type I, IIB, IIA
Type I-slow activity Type IIA- fast activity Type IIB- fast activity
contact dermatitis is _____ hypersensitivity
Type IV
UT-A2 carrier is increased by what? Works where and does what?
UT-A2 carrier helps with Urea secretion into the thin limbs of the loop of henle it is increased by ADH
Dysmetria=
Undershoot or overshoot of intended position with the hand, arm, leg or eye. Due to loss of the ability to predict how far movements will go. Overshoot occurs which appears as an intention tremor. A type of ataxia, which is lack of coordination of muscle movement Damage to cerebellum....
what is the equation for excretion rate of substance
Uv x [X]urine (multiplication) Uv=urine flow rate Xurine=concentration in urine remeber that certain substances like glucose should have 0 concentration in urine
which has a faster response to depolarization, the V-Gated Na+ gate? or the v-gated K+ gate?
V-gated Na+ gate is way faster V-gated K+ gate as a slow delay as the VG Na+ inactivation gate closes
in terms of gates whats the difference between V-gated K+ and V-gated Na+
V-gated Na+ has both an activation gate and an inactivation gate V-gated K+ only has an activation gate which is slow delayed to where it only opens once Na+ inactivation gate starts closing
fast, shallow breaths in the upright position cause _______ mismatch because ________
V/Q mismatch because air flows to upper lobes and blood flows to lower lobes
What are the two receptors for ADH and what does each do
V1-contraction of vascular smooth muscle V2-insertion of aquaporin-2 into the apical membrane of tubular epithelial cells, Also aquaporin 3 and 4 on the basolateral membrane
vital capacity=
VC=IRV + ERV + TV moveable air
what kind of turn over rate do taste receptor cells have?
VERY HIGH
what is the required cofactor for IXa to convert X into Xa
VIII
what is the required cofactor enzyme IX
VIII this is missing or messed up in hemophilia
what happens to small vessels that do constrict in response to increased MAP chronically (hypertension)
VSM growth around narrowed lumen (decreased radius and increased resistance) No change in total cross sectional area of vessel inward eutrophic remodeling
what can be used to determine the mean electrical axis of heart
Vector analysis mean electrical axis of heart describes the direction of the QRS vector (ventricular depolarization)
where are the third order neurons of taste sensation locatied>
Ventral posteromedial nucleus of the thalamus
Causes of Hypokalemia
Very low intake of K + GI loss of K+ - diarrhea Metabolic alkalosis Excess insulin Increased distal tubular flow -salt wasting nephropathies(cant reabsorb sodium) -osmotic diuretics - loop diuretics Excess aldosterone
what pathway facilitates quick movements in reaction to sudden changes in body position? and provides control of antigravity muscles?
Vestibulospinal pathway
what does calcitriol do in regards to calcium
Vit D3 enhances intestinal absorption of calcium
what vitamin is absorbed in the colon and what allows for this
Vitamin K produced by the lovely colon bacteria
what creates the +8mV charge in the tubular lumen of the thick ascending limb?
Voltage gradient created by K+ back diffusion through high intracellular K+ and leak channels
without glomerulotubular balance what would happen when GFR increased
WITHOUT the glomerulotubular response an increase in GFR would cause decreased resorption and increased urine volume secretion this would cause us to lose a ton of water unnecesssarily
what are the systemic controls of RBF (and GFR)
Sympathetic NS and Epinephrine (vasoconstrictors) Renin-angiotensin system(vasoconstriction) ANP-artial natriuretic peptide (vasocdilators)
T/F smooth muscle has pacemaker cells that spontaneosly generate APs like AR cells
T
describe plasminogen activation
T-Pa activates by cleaving into plasmin plasmin breaks down fibrinogen, fibrin and prothrombin and factors V, VII and XII
what are the two proteins that make a dimer for sweet taste receptor
T1R2 and T1R3
Which is more potent? T3 or T4?
T3
triiodothyronine=
T3
what would happen to ACTH levels in hyperthyroidism?
T3/T4 inhibits glucocorticoids which would cause an increase ACTH levels
thyroxine=
T4
which thyroid hormone is MOST responsible for negative feedback mechanisms to the Anterior pituitary and hypothalamus. Which of those is MOST of the negative feedback occuring at?
T4 is most responsible because it is the main circulating form negative feedback mainly occurs at the level of the anterior pit
PTH acts where in the nephron and does what
TAL and DT increases the Ca++ ATPase on the basolateral
total lung capacity=
TLC=VC + RV, where VC=IRV + ERV + TV
alveoli are _______ and more_ _____ in zone 3
smaller and more compliant in zone 3 larger and less compliant in zone 1 this means that alveoli at the base of the lung recieve more ventilation than those in the apex
what muscle type has alpha actinin to attach actin to dense bodies
smooth muscle
what muscle type has higher levels of actin
smooth muscle
what are some contractile differences between smooth muscle and skeletal
smooth muscle contractions are slow to develop last significantly longer maximum force generation is greater primariliy oxidative metabolism
describe the mechanism of lymph flow
smooth muscle in the wall of the lymphatics exerts a pumplike action lymphatic vessels have valves similar to those in veins skeletal muscle pumps and thoracic pump
what are the mechanisms of lymph flow
smooth muscle in wall of lymphatics will exert a pump like action lymphatic vessels have valves similar to veins skeletal muscle pump and thoracic pump
What are precapillary sphincters?
smooth muscle sphincters that control entracnce to capillaries
where are the beta 2 receptors located and what is the major function
smooth muscle, liver, heart relaxes SM, increases glycogenolysis, increased HR and force
what muscle type has actin filaments that are longer
smooth muscles
what causes pulsative pressure to disappear in capillaries
smoothing out due to decreasing elastic/collagen tissue and increases resistance as you move through arteries to capillaries Damping=Rxcompliance
the rate of gastric emptying is influenced by
solid vs liquid(liquid fastest) Nutrient content(carbs fastest, proteins, fat (slowest) force of gastric contractions (more contractions=faster emptying)
what is the first precursor to produce thyroxine and and triiodothyronine
tyrosine which then gets iodinated 3-4 times via peroxidase action in the colloid
are the paraventricular and supraoptic neurons myelinated or unmyelinated?
unmyelinated
Sympathetic motor function nerves use what type of nerve fibers
unmyelinated type C slow AF
what are the inhibtors of GH release
somatosatin IGF-1 glucose FFA
GHIH=
somatostatin
what inhibits oxyntic cells
somatostatin from D-cells
which taste receptors utilize ion channel linked receptors
sour and salty
what type of summation occurs during muscle contraction?
spatial summation with asynchronous recruitment
which esophageal sphincter relaxes during swallowing
upper
what filters RBCs
spleen and liver
describe intersittial cells of cajal actions
spontaneous activation of pacemaker current leads to BER(basic electrical rhythm) electrotonic conduction of slow waves. if stimulated the waves increase enough for contraction this occurs through depolarization and activation of the L-type Ca2+ channels
anti-inflammatory actions of cortisol
stabilizes the lysomal membrane decreases capillary permeability decreases WBC migration and phagocytosis suppresses T-lymphocytes proliferation decrease IL-1
describe esophageal sphincter muscle movements during swallowings
upper and lower sphincters remain closed between swallows (have tonic contractivle properties) upper esophageal sphincter relaxes during swallow lower esophageal sphincter relaxes as peristaltic wave approaches
what are ALL of the muscles of inspiration
sternocleidomastoid scalenes external intercosals diaphragm
what hormones need to be bound to specific transport proteins?
steroid hormones(mineralcorticoid, glucocorticoids, androgens) and thyroid hormones(T3/T4)
cortisol has what effects on metabolism
stimualtes gluconeogenesis and glycogenolysis (increase blood glucose) ANTI insulin action (decreases glucose uptake in myscle and fat but NOT brain and heart proteolysis and inhibition of protein synthesis lipolysis promotion AND lipid deposition in certain areas
thromboxane A2 will
stimulate aggregation and activation
Powerful isometric contractions (load is greater than force supplied by muscles) will stimulate _____________
stimulates BOTH THE JAW CLOSING AND OPENING MUSCLES JAW openers will keep the jaw from SNAPPING shut
what are the effector responses of angiotensin II
stimulates aldosterone production Directly increaess Na+ reabsoprtion in the proximal, loop, distal, and collecting tubules) constricts efferent arterioles and enhances peritubular capillary reabsorption(decreased Pc in peritubular capillaries and increased colloiud osmotic pressure of the capillary) , increases Pg which increases the filtration fraction
why does glucocorticoid treatment cause osteoporosis
stimulates bone resorption (Via increases RANK-L expression inhibits osteoblastic maturation and activity promotes apotosis of osteoblasts and osteocytes
what are the two actions of oxytocin
stimulates contraction of uterus towards end of gestation and causes milk ejection from the breasts in lactation
motilin does what
stimulates migrating motility complex in the fasting pattern of SI
during the gastric phase of acid secretion distension has what two effects
stimulation of enteric neurons to release (Ach)= Ach stimulates Parietal, ECl AND G cells stimulates G-cells to produce gastrin
activation of central chemoreceptors causes what
stimulation of the Dorsal Respiratory Group INCREASE RATE OF BREATHING
what are all of the stimuli for GH release what about the inhibitory factors
stimuli-sleep, hypoglycemia, stress inhibitors-aging, disease, glucose
Give all steps in the systemic homeostatic process mediated by NS or ES
stimulus reflex receptor Afferent pathway (only in NS) integrating center Efferent pathway Effector Effector response
when does protein digestion begin
stomach by pepsin (pesinogogen from chief cells + HCl from parietal cells=pepsin)
fat digestion begins in the _______ with _______
stomach lingual lipase
stomach stretch initiates the gastric receptive relaxation through both _________ while duodenal stretch stimulates the gastric receptive relaxation through _______
stomach stretch---->both long and short pathways of activating ENS to release NO and VIP duodenal stretch is activating via a short pathway
where else in the body are taste receptor found?
stomach, bile duct, intestines, bronchi and kidneys
what does vitamin B12 bind in the following areas? stomach duodenum illeum
stomach-binds to R-binding protein duodenum-R-binding protein broken down, B12 binds instrinic factor illeum-B12-intrinsic factor complex binds the IFCR receptors and then once inside cell intrinsic factor is broken down and B12 binds TCII
what stimulates growth hormone secretion
stravation (protein deficiency) Fasting (hypoglycemia) Stress Exercise Excitement
what allows for the long half life of T4 (6-7 day half-life) why does T3 have a shorter half life
strength of its binding to the transport proteins doesnt bind as tightly
streptokinase and T-pa act to ________ aminocaproic acid and transexamic acid act to ______
streptokinase and T-pa will form plasmin (clot eater) aminocaproic acid and transexamic acid will inhibit formation of plasmin (increases clotting)
what can stimulate smooth muscle contraction
stretch ligands intrinsic activty
what are the local factors for smooth muscle contraction
stretch (contraction) NO (relaxation) aciditiy, CO2 and O2 levels, ions in the ECM HORMONES and NTS ARE NOTTTTTTT LOCAL factors
what two things will initiate the gastric receptive relaxation
stretch of gastric or duodenal wall protein or fat in the duodenum ENS (Short) and vaso-vagal reflexes control controlled by NO and VIP release from ENS
stimuli for the gastric receptive relaxation
stretch of gastric or duodenal wall proteins and fat in the duodenum CCK ENS and Vago vagal reflexes (ie short and long) NO, VIP release by ENS
what is the hering breuer reflex
stretch receptors in the bronchi and bronchioles are activated when lungs over stretch (3x normal tidal volume) stops further insipiration and decreases rate regulate rate and depth
what determines pulse pressure(difference between systolic and diastolic)
stroke volume and arterial compliance
what are the most important factors on determining the magnitude of pulse pressure
stroke volume and arterial compliance PP=SV/C
intrapleural pressure is ______
subatmospheric ensures that lungs are held to the chest wall and will move with the chest wall during inspiration and expiration
unstimulated saliva production is mainlly from what gland
submandibular
what is the enteric nervous system composed of?
submucosal and myenteric plexus "little brain)
what creates 40-50%(500-600mOsm) of the medullary interstitial osmolarity (500-600 mOsm/L)
urea absorption
what is transient vascular shock
sun heats on your skin which then vasodilates and allows blood to pool upon standing this causes obvious problems with dizziness
superior mesenteric artery supplies ______ celiac artery supplies ______
superior mesenteric--->pancreas, small intestine, colon (also inferior mesenteric supplies colon) celiac artery--> liver, spleen, stomach
where is urea absorbed in the nephron? where is it secreted?
urea is absorbed in the proximal tubule and in the medullary collecting duct (increased by ADH) urea is secreted in the descending and ascending thin limbs of the loop of henle the thick ascending, distal convoluted tubule and cortical collecting duct are impermeable to urea with no effect by ADH
the net movement of any substance across the intestinal epithelium is influenced by _________ and _______
surface area and motility
surface cells in the small intestine _________ crypt cells ________
surface cells are mature and absorb Na+, Cl- and H2O crypt cells are immature and found deep, they secrete Na+, Cl- and H2O the absorption at the top and secretion at the bottom creates fluid flow
surface cells use _______ and _______ transport for Na+, Cl- and H20 absorption while Crypt cells use only ________ for Na+, Cl- and H2O secretion
surface cells-prandial-electrogenic Na+/Glucose transport, post prandial-electroneutral Na+ and Cl- Crypt cells use electrogenic Cl- transport for secretion, VIP and PGE2 active cAMP on basolateral leading to Cl- CFTR transporter activation apically
pyloric gland cells in stomach
surface mucous cells-HCO3-, mucous, trefoil mucous neck cell g cell-gastrin D cell-somatostatin
antigens are usually ______
surface peptides or polysacc
what accounts for two thirds of pulmonary elasticity
surface tension
what are aldosterones effects (specific scenarios) on the sweat glands vs the salivary glands
sweat glands- converses salts in hot environments salivary glands-converses sodium during high rights of salivary secretion
what is a scenario in which you would have a decrease in osmolarity with no change in volume
sweating and replacing it with plain water (isotonic solution)
what is the function of the migrating motility complex
sweeps ingested solids that cannot be digested out of the stomach and through the intestinal tract 90 mins to go from stomach to colon
what nervous system can cause venoconstriction?
sympathetic no parasympathetics in veins
what is phospholamban involved with?
sympathetic activation of cardiac muscle through epi and norepi binding of B1 receptors binding of B1 activates phospholamban which increases the activity of Ca2+ ATPase on the SR this acts to increase Ca2+ stores--->increases Ca2+ release--->IINCREASES FORCE OF CONTRACTION AND increases Ca2+ removal time---> shortens Ca2+ troponin binding time---> SHORTER DURATION OF CONTRACTION (FASTER)
sympathetic nervous system can do what to cardiac function? what about parasympathetic?
sympathetic can do three things (can increase HR, can increase SV(through contraction actions), can vasoconstrict/venoconstrict) parasymphatic can only do one main thing decrease HR through SA node parasympathetic can also vasodilate the sex organs but this isnt very important to cardiac function
what is the exception to the rule that sympathetic post ganglionic only use norepinephrine?
sympathetic post ganglionic terminals release ACh at sweat glands to activate muscarinic receptors
in the ENS describe sympathetic influence
sympathetic postganglionic neurons will stimulate or MOSTLY inhibit neurons in the myenteric plexus and submucosal plexus via NE
difference between parasympathetic and sympathetic innervation in the GUT
sympathetic- post-ganglionic fibers (NEpi) to enteric nervous system, vasculature, ducts, parenchyma, usually inhibitory parasympathetic(vagusm pelvic)-post ganglionic fibers (ACh) act locally, actions are stimulatory or inhibitory, depending on final neurotransmitter receptor
axoaxonal synapses
synapses terminate on an axon often close to synaptic terminals and modulate the release of neurotransmitters
axodendritic synapses=
synapses terminate on dendrites or dendrites spines and tend to be excitatory
axosomatic synapses=
synapses terminate on neuron cell bodies and tend to be inhibitory
what is vitamin Ks function
synthesis of clotting factors and prothrombin
what are some of T3s actions at the target tissues
synthesis of new prots Growth CNS development Cardiovascular-increased output, tissue blood flow, heart rate, heart strength and increased respiration Metabolism- Increases the following.... mitochondria, Na+/K+ ATPase, O2 consumption, glucose absorption, gluconeogenesis glycogenolysis, lipolysis and BMR
control systems in GI ____________ Control mechanisms in GI _______
systems regulate conditions in the lumen of the tract(not ECF conditions) mechanisms are governed by volume and composition of the luminal contents
which heart failure type has decreased SV at any given EDV
systolic ventricles lose contractibility
CD4 cells are and they ?
t helper cells bind to APCs and activate two branches of the acquired immunity:humoral and cell mediated
right shift (>59 degrees)
tall lanky people right ventricular hypertrophy at the end of inspiration
what things activate parasympathetic stimulated saliva production (Innate)
taste (especially sour) and TACTILE stimuli on the tongue surface smell of food (especially if the food is NOT liked) ingestion of irritating foods nausea
what are the functional units of gustation?
taste buds
which midbrain tract rises from the superior and inferior colliculi and causes head turning in response to sudden visual or auditory stimuli?
tectospinal tract
where does the conducting zone of the lungs end
terminal bronchioles
what part of the brain plays a key role in both the afferent and efferent pathways
thalamus in the diencephalon
what is inside the diencephalon
thalamus-sensory relay and motor control pathway synapses hypothalamus-homeostasis epithalamus-contrains pineal body(melatonin releas) circadian rhythms substhalamus-involved in the basal ganglia and control of control of voluntary movement movement
unlike most immune reactions a person already has antibodies/agglutinins (IgMs) to _____
the A/B antigens NOT on their RBCs
What valves are open during late ventricular diastole?
the AV valves open (low pressure in ventricles but higher pressure in artia and systemic circulation) period of passive filling begins
how does the thyroid increase intracellular I- concentrations?
the Na+/I- symporter Na+ moving down its gradient into the cell provides energy to move Iodide in secondary active symporter
parasympathetics act only on
the SA node in the artia NO ACTIONS ON THE VENTRICLES
the absorption rate of Na+ and H2O is _______ in the proximal tubule?
the absorption rates of Na+ and H2O are the SAME in the PCT isotonic solution reabsorbed
Cardiac muscle contraction strength is dependent on
the amount of Ca++ released Concentrations can be adjusted to increase strength of contraction
what area has a higher V/Q ratio in the lung
the apex of the lung as one moves from Zone 1 to Zone 3 there is a slower increase in ventilation than blood flow
what controls the cyclical movements of mastication muscles. what part of brain?
the central pattern generator in the brainstem, when stimulated it elicits rhythmic, coordinated activation and inactivation of the jaw-closers and jaw-openers
what pathway do steroidal anti inflammatory drugs inhibit (predinose)
the cleavage of membrane phospholipid into arachidonic acid by inhibition of phospholipase A prevents formation of COX-->Prostaglandins and thromboxanes AND Leuktrienes
what helps to create the plateu effect seen in a contractile heart muscle AP
the closing of transient K+ channels along with long acting Ca++ channels being opened
why must acid from the stomach be neutralized in the small intestine?
the digestive enzymes in the small intestine require a netural pH to function HCO3- is secreted from bile and pancreas
give a mechanistic explanation of why albuterol helps asthma patients
the drug is a Beta 2 selective agonist which acts to cause bronchodilation
what creates the hyperosmotic medullary interstitial fluid
the entire loop of henle is required: water reabsorption in the descending limb will help create a gradient for solute reabsorption in the TAL which creates most of the hyperosmotic meduallary interstitial fluid another contributing factor is urea reabsorption and secretion in the presence of ADH (40-50%)
saturation refers to _______ and dependent on __________ (2 things)
the fraction of total binding sites that are occupied at any given time dependent on protein concentration and the substance (ligand) concentration
What is the difference between the actions of thyroid stimulating immunoglobulin (graves disease) and normal TSH
the immunoglobulin form has a PROLONGED stimulating effect on the thyroid gland, lasting as long as 12 hours in contrast to TSH (1 hour)
what do kidneys do in response to chronically increased CO2 levels
the kidneys resorb more bicarbonate and this ultimately lowers free H+ levels in the CSF of the brain this is why central chemoreceptors stop responding to low CO2
which olfactory pathway gives the automatic but learned control of food intake and aversion to toxic and unhealthy foods
the less old olfactory system-to limbic system (hipposcampus)
GH causes the release of IGF-1 in what organ?
the liver
where is Vit D3 stored?
the liver
where is the MAJOR site of IGF-1 synthesis
the liver ALTHOUGH it can be produced in most tissues
decreases to intraplural pressure will mean ________ in volume of lung
the more negative the Pip the greater the increase to Ptp which causes increases in lung volume
what contains the intrafusal fibers?
the muscle spindle which is WITHIN the
what would happen if intrafusal fibers did not contract in response to stretch activation of the spindle reflex through gamma motor neurons
the sensory fibers would not be able to sense further change in muscle length since there would be slack
what allows the muscle to maintain sensitivity to changes in muscle length
the spindle reflex action of the alpha motor neuron (contraction of extrafusal) and the followed response of the gamma motor neuron (contraction of the intrafusal fibers) intrafusal has sensory nerves to send afferent info about the contraction
which part of the loop of henle is the only part that has H2O permeability
the thin descending limb Both thick and thin ascending are impermeable to water
where in the oral cavity is there the most sensitve thermoreceptors?
the tongue
what is the strength of the electrical gradient dependent on?
the valence of the ion and the magnitude of the membrane potential
what thermoreceptors in the orofacial region are MOST sensitve to changes in temperature?
thermoreceptors on the tongue
what is function of micelles
these act to solubilize the breakdown products of triglycerides so that lipases can act on remaining fat more efficiently they also transport the TG breakdown products to the brush border
what do the following diuretics all act to inhibit? Furosemide Ethacrynic acid Bumetanide
these all inhibit the Na+/2Cl-/K+ co transporter in the TAL
give me a mechanistic explanation for how aldosterone, insulin or B2-adrenergic receptor activation would cause a decrease [K+] in the ECF
these are all things that will increase the activity of the Na+/K+ ATPase pump in muscle cells which brings K+ into the cell which decreases K+ in the ECF
UT-A1 and UT-A3 carriers are increased by what and work where? What they do?
these are increased by ADH and make the medullary collecting duct more permeable to urea by allowing for facilitated diffusion (reabsorption back into the interstitial space) this creates 40-50% of the hyperosmotic (500-600 mOsm) of the interstitial fluid
arteriolar dilation and constriction have what effect on net filtration
these both effect Pc dialation will increase blood flow into the capillary and increase capillary pressure thus increases filtration constriction will decrease blood flow into the capillary and decrease capillary pressure thus decrease filtration
what do aminocaproic acid and transexamacid do?
these prevent cleavage of plasminogen into plasmin this prevents clot break down
explain why aldosterone and ang II are NOT the main regulators of concentration of [Na+] in the ECF
these will alter the Na+ mass but not the concentration of Na+, remember that water always follows sodium so increases to Na+ reabsorption means H2O reabsorption thus no change in concentration you must either reabsorb or not reabsorb H2O (via ADH) to control Na+ concentration. You can also do this via the thirst mechanism.
all mechansims of sour taste receptors result in _______
they all lead to depolarization of receptor cells
warm and cool receptors are best able to detect a change at____________ and if ________ are activated the system is even better able to discern small changes in temp
they are best able to detect at the midrange of their temp sensitivity if nociceptors are simulataneously activated then they are even better
at average skin temp 34-35 degrees describe the activation of cold and warm receptors
they are equal
what are intrafusal fibers and what do they detect?
they are fibers within the extrafusal fibers that have sensory nerve endings wrapped around them so that they ARE SENSITIVE TO CHANGES IN MUSCLE LENGTH
what is oral rehydration therapy and how does it work to treat patients with enterotoxin (bacteria) induced diarrhea
they drink water, salt and glucose mixture glucose is uptaken in the intestines by a SGLT1 transporter that brings in Na+ aswell this helps offset the loss of fluid from increased CFTR channel in the crypt cells
why is blood velocity slowest in capillary bedS?
they have a greater cross sectional area
How do thyroid hormones interact with the catecholamines?
they have permission action of the catecholamines
what happens when smooth muscles are stretched
they respond by opening mechanosensitive ion channels that depolarize the membrane and contract the muscle to oppose the stretch
what happens when golgi tendon organs recieve extreme stretch afferent sensory info)
they stimulate an inhibitory interneuron this neuron decreases the activity of the alpha motor neuron skeletal muscle contraction is decreased (relaxation)
compitive inhibtiors will do what to transport rates/rates of reaction?
they will decrease the transport rate of the endogeneous ligand
absorption of water soluble vitamins occurs where and how?
thiamin, riboflavin, niacin, pyridoxine, pantothenate, biotin, and ascorbic acid are all cotransported with Na+ in the upper small intestine
what allows the atria and the ventricles to function as seperate syncytiums
thick fibrous tissue seperating the artia from the ventricles it prevents any inappropriate communication between the compartments outside of the conductive pathways and it provides a brief break in time between contraction of the atria and venticles
what diseases can lower Kf (glomerular capillary filtration coefficient)
thickened basement membrane, hypertension, diabetes mellitus decreased capillary surface area; glomerulonephritis
An abnormally low DLCO (diffusing capacity of CO) might indicate. THis would mean what for the PAO2-PaO2 gradient?
thickening of barrier (edema or fibrosis) Decreased surface area (emphysena, low CO, Tumors, ventiliation-perfusion mismatch) Decreased uptake (anemia and decreased blood volume in pulmonary capillaries INCREASED PAO2-PaO2 gradient
what can cause an abnormally low DCLO test
thickening of barrier(increased d)-interstitial edema or fibrosis) decreased surface area(decreased A)-emphysema, low CO, tumors, ventilation perfusion mismatch) Decreased upstake-anemia, decreased bloodvolume in pulmonary capillaries
what is the only part of the loop of henle that is permeable to water
thin descending limb
which parts of the loop of henle have urea secretion via facilitated diffusion
thin descending limb thin ascending limb
where in the nephron would you see excess H+ secretion via the ammonia buffer system where glutamine metabolism is being used to create NH4 and HCO3-. AND NH4+ is secreted on the apical side via a NH4+/Na+ transporter and HCO3- exits into the interstitial fluid
this ammonia buffer process would occur only in the PT, TAL and DT SIDE note: in the CD, ammonia and primary active H+ secretion are used to create NH4+ instead
veins have _____ layers
three distinct layers (tunics) Walls are thinner than arteries so they often appear collapsed in histological slides
what determines the amplitude of normal range in a reflex receptor?
threshold stimulus (sensitivity)
what does thromboplastin have that activated partial thromboplastin not have
thromboplastin has tissue factor to help test the extrinsic pathway (PT test)
how do amino acids exit the intestinal cells?
through amino acid transporters on the basolateral surface
provide a mechanistic explanation for how Angiotensin II could cause alkalosis?
through increased activity of the Na+/H+ transporter on the apical side of proximal , loop, distal and collecting tubules
how are chief cells mainly activated?
through local and vagal reflexes that release Ach
what is the main activation pathway of chiefs cell secretion
through local and vagal reflexes that release Ach
how do activated osteoblasts activate osteoclast activity in response to PTH?how do osteoblasts inhibit osteoclasts in response to estrogens and calcitonin
through production of RANKL which binds RANK and activates osteoclasts estrogens and calcitonin cause osteoblasts to secrete OPG which binds RANKL and prevents its binding to osteoclasts which inhibits their activity
albumin can bind what hormones
thyroid hormone estrogen and testosterone
what are the amine hormones and what are they derived from
thyroid hormone and epinephrine and norepinephrine derived from tyrosine
both thyroid hormone and GH stimulate protein synthesis, bone formatiom, protein synthesis/catabolism as well as increase fat metabolism(lipolysis) but there is a significant metabolic difference between them, what is it?
thyroid hormone causes rapid uptake of glucose by cells and enhances glycolysis and gluconeogenesis (also increease rate of CHO absrption) where as GH does the opposite and has anti-insulin (anti glucose uptake) action
what are the lipophilic hormones
thyroid hormones (amine hormone, tyrosine derived) steroid hormones(aldosterone, androgens, cortisol)
which amine hormones use nuclear receptors? which amine hormones use plasma receptors?
thyroid hormones use nuclear receptors will epinephrine and norephinephrine use plasma receptors
thyrotoxicosis=
thyroid storm Elevated Thyroid Hormone with stressful events (trauma, surgery, severe emotional distress) or serious illness (DKA, MI, etc.). Symptoms: fever, tachycardia, elevated BP, nausea, vomiting, diarrhea, breathing problems, etc. administration of epinephrine is contraindicated and elective dental care should be deferred.
minute,pulmonary or total ventilation=
tidal volume x respiration rate (breaths/minute)
tight junctions= desmosomes=
tight junctions-prevent intercellular movement of fluid and dissolved substances desmosomes=structural support
what is MHC class II's purpose
to present antigens to T helpers and activate them creates clones and recruits cell mediated
where are taste papillae located
tongue, hard and soft palate, pharynx, epiglottis and larynx
tonic receptors help differentiate stimulus _________ while phasic (fast) receptors help differentiate stimulus ______
tonic-stimulus intensity phasic-stimulus duration
tonic= phasic=
tonic=slow adaption phasic=fast adaption
which will give you information on the movement of H20 via osmosis?, tonicity or osmolarity?
tonicity (looks at the impermeable stuff) thus the stuff that determines osmotic movement hypertonic-concentration of impermeable solute is greater outside the cell than inside thus water will flow out of the cell and shrink
what are 3 factors affecting Mean arterial pressure
total blood volume flow in(CO) and flow out(TPR) distribution of blood (blood shifts from veins to arteries)
as you move from the conducting zone to the respiratory zone the total cross sectional area ____________ thus the air velocity is _______
total cross sectional area increases which reduceds the velocity of the air will the flow remains constant velocity=Flow/Cross-sectional area
what is the difference between the tactile sensations of touch, pressure and vibration
touch is receptors in the skin or tissues beneath pressure is deep tissue vibration is rapidly repetitive signals
what direction does the myosin head move when ATP is hydrolyzed
towards the z-line
TRP=
transient receptor potential (thermal receptor channels)
gas exhange at the respiratory membrane depends on
transport rate through the membrane (V=deltaPxAxS/(d x (MW)^.5) rate of alveolar ventilation
what vasoactive response does LOW CO2 have in the alveoli
trick question!!!! nothing listed about low CO2 HIGH CO2 is listed as a vasoconstrictor in the alveoli though
what happens to mineralcorticoid levels in secondary hypoadrenalism
trick question, nothing happens to mineralcorticoid levels in secondary because its an ACTH release which doesnt affect aldosterone (RAAS controlled)
what is the most abundant dietary fat=
triglycerides
what are fats that we ingest and need digestion
triglycerides=main fat smaller amounts of cholesterol, cholesterol esters and phospholipids
what is a second degree heart block
When there is a normal heartbeat, then a few P waves with out QRS complexes
what is the anatomical organziation of skeletal muscle
Whole muscle Muscle Fasicles(where the cells are) Muscle Fibers(cells) Myofibrils Myofilaments
sweet receptors are usually ________ on the same cells has bitter and umami
usually not on the same cells
what loading conditions will produce maximum velocity?
ZERO load
what is the largest layer of the adrenal cortex and what does it produce?
Zona fasciculata=glucocorticoids
bitter taste stimuli are usually ________ and examples are
usually organic denatonium, caffeine, strychine, quinine, nicotine, broccoli and brussels sprouts
what can cause a loss of H+ in bthe body
utilization of H+ in the metabolism of various organic anions Loss of H+ in vomitus Loss of H+ in the urine Hyperventilation
where does the phosphate buffer system work in the nephron (note: this is in the case of excess H+, up to 500 mEq/day being buffered and secreted)
utilizes the Na+/H+ secondary active antiporter for secretion of H+ into the lumen on the apical side this means that it must be occurring in the proximal tubule, TAL and early distal tubule
which neurons are involved in the primary peristalsis response in the esophagus
vagal afferent travels to brain (Dorsal vagal complex) parasympathetic preganglionic travels ORAD and stimulates postganglionic parasympathetic (Myentertic nerve) to release Ach to contract parasympathetic preganglionic travels CAUDAD and stimulates myenteric nerve(postganglionic) to release NO and relax muscle
an iron deficiency would cause
a Hb deficiency
what is autotransfusion
a RAPID compensatory mechnanism for hemorrhage where there is movement of intersitial fluid into the capillaries arteriolar constriction (decreased Pc) net absorption of fluid into the capillaries
what is transthyretin
a binding protein for T3/T4
which oral cavity thermoreceptor is activated by capsaicin, temps greater than 43 degrees C and protons
vanilloid Receptor Subtype (TRPV1 receptors
thermal receptors are activated by?
a change in metabolic rate or binding a ligand
what is clonal anergy?
a form of peripheral tolerance where cells that are self antigenic become non function
what is tonic level of activity in homeostatic processes
a homeostatic pathway is neither completely shut off or fully active think blood vessels (two signals firing at once keep blood vessels in tonic control) only goes up or down with a change in signal rate more signaling=constriction less signaling=dilation
emphysema is a ______ disease that _______ compliance causes ________ breathing
a obstructive lung disease (loss of elastic fibers) increases compliance slow and deep breaths
what is plasminogen
a plasma protein that is within clots, endothelial cells release t-PA which turns it into plasmin a few days after clot formation Plasmin digests fibrin fibers, fibrinogen, prombrin and factors V,VIII,XIII
what is the labeled line principle
a precise modality activates specific receptors and postsynaptic cells
describe why transcellular reabsorption of Cl- is only done in the late proximal tubule?
a secondary active formate/Cl- antiporter is here also basolateral facilated diffusion can be accomplished
what is PAH?
a secretion product in the kidneys PAH=Paraaminohippuric Acid
what is antagonisitic control
a single systemic effector is controlled by two different efferent pathways working in opposition ex. glucose levels (insulin release and glucagon release)
what is the rubrospinal tract
a tract that takes info from the red nucleus and crosses over to the opposite side of the brainstem and travels alongside the corticospinal tract into the lateral columns functions as an accessory route for transmission of singals from the primary motor cortex to the spinal cord
what is a paraneoplastic endocrine syndrome?
a tumor that secretes tropic hormones that can cause secretion of more hormones in a Secondary hypersecretion
what is a likely factor in secondary hyperparathyroidism
a vitamin D deficiency high levels of PTH from hypocalcemia vit D3 needed for normal Ca++ absorption in the intestines
what is the dark band of skeletal muscle
a-band
what are angiotensin IIs main effects(4 things that all lead to increased BP)
vasoconstriction thirst stimulation ADH secretion ALDOSTERONE SECRETION
increases blood vessel tone will
vasoconstriction and decreased lumen diameter
what are all the things that angiotensin II can do in response to low MAP
vasoconstriction of arterioles increased CO increased ADH and thirst Increased aldosterone release--->increased Na+ reabsorption
how is blood shifted from veins to arteries? What does this do to MAP
vasoconstriction of veins Increase MAP
if PAO2 (aveolar O2) drops what will happen to pulmonary blood vessels
vasocontriction helps match perfusion to ventiliation
vasopressin, endothelin, norepinphrine and angiotensin act as __________ in the pulmonary arterioles
vasocontrictors
decreased oxygen, increased CO2 , increased H+ or K+ will do what to arteries
vasodilation
what are the exceptions to the fact that PNS receptors dont effect arteriole size?
vasodilation of salivary gland arterioles by muscarnic receptors a couple of arterioles in the gastric and intestinal glands
between heart beats describe pressures in veins, arteries, atria, and ventricles
veins have greater pressure than atria atria have greater pressure than ventricles arteries have greater pressure than ventricles blood flows in to atria and into ventricles semilunar valves are closed and AV valves are open
what are the mechanisms for venous return
venous valves respiratory pump-pressure changes in the central cavity due to the pressure changes from breathing Skeletal muscle pump-when muscles contract they squeeze the veins whihc results in blood moving through the heart
where are the third order neurons for taste receptors located
ventral posteromedial nucleus of the thalamus
what is the medullary center for active expiration and greater than normal inspiration
ventral respiratory group-nucleus ambiguus and nucleus retroambiguus
where are the central chemoreceptors located
ventral surface of the medulla
where can lipid deposition occur with high levels of cortisol
abdomen, interscapular "buffalo hump" and rounded moon face
hemoglobin S has abnormal ______ that cause ________
abnormal beta chains lower O2 affinity when deoxygenated RBCs form sickles
cyctic fibrosis has what effects
abnormal sweat composition decreased pulmonary and pancreatic secretion Defective CFTR sweat Cl- reabsorption sucks pancreatic duct cells cant increase Cl- pulmonary mucus clearance sucks too
T wave represents
ventricular repolarization
what tract controls automatic control of breathing
ventrolateral tract primarily controlled by changes in PCO2 less sensitive to PO2 and H+ pulmonary mechanical receptors activated b respiratory centers in pons and medulla
absolute refractory period= relative refractory period=
absolute refractory period=impossible to fire another AP, due to all or none activation and v-gated Na+ channels closed inactivation gates relative refractory period=larger than normal EPSP can elicit an action potential (some Na+ channels resetting to resting state after hyper polarization)
absorbing colon= storage colon=
absorbing colon is the proximal 1/2, absorption of the water, electrolytes forms solid fecesssss stoage=distal 1/2
where are the control points of calcium and phosphate levels
absorption-via intestines excretion-via urine (Ca and P) and feces (Ca+ ONLY) temporary storage-bones hydroxyapatite of ground substance
what is receptive relaxation?
accomadates volume of meal in stomach reduces pressure increases preventing gastric reflux and premature gastric emptying
What are the parasympathetic mechanisms to reduce HR?
ach/muscarinic binding decreases F-type channels increases K+ channel(hyperpolarizes Vm) increases time to threshold and decreases HR
what is the function of the Hering Breuer Reflex
achieve optimal rate and depth of respiration stretch receptors in bronchi and bronchioles are activated when the lungs OVER stretch (tidal voolume >3 times) stops further inspiration and decreases rate
what is the most common form of dwarfism
achondroplasia
describe levels of histamine, acetylcholine, somatostatin and gastrin in the interdigestive period
acid being secreted at low levels, but no buffer means low pH basal secretions stimulated by histamine and Ach but LOW gastrin due to low pH via high somatostatin release possibly functions to sterilize the gastric lumen
which pancreatic cells synthesize and secrete hydrolases
acinar cells
what is hirsuitism and what causes it
acne and excessive facial hair hypercortisolism (cushing syndrome/disease)
what kind of signal coding occurs with smell and taste
across fiber pattern code information conveyed by relative amount of activity across multipole differentially sensitive elements in an array
while touch and pressure receptors typically use a labeled line to differentiate location of sensory receptor olfaction uses what?
across-fiber pattern code information conveyed by relative amounts of activity across multiple, differentially sensitive elements in an array
which filament gets pulled toward the middle of the sacromere
actin
what do platelets contain?
actin and myosin enzymes and organelles for aerobic CR enzymes for prostaglandin synthesis fibrin-stabilizing factor (important for hemostatsis) growth factors that stimulate endothelial cell, VSM, and fibroblasts to divide and grow
streptokinase does what
activates plasminogen into plasmin which increases clot break down
what is the stimulus for the muscle spindle reflex? what happens when afferent info from the spindle enters the spinal cord
activation of both the alpha and gamma neurons alpha motor neuron- this stimulates muscle (extrafusal fiber) contractions and INHIBITION of the alpha motor neurons of antagonistic muscles gamma motor neuron- stimulates the intrafusal fiber contractions
bile salts are ________ resorbed
actively in the illeum Apical sodium dependent bile salt transporter (ASBT)
what is the automatic control tract for breathing(primarily controlled by changes in PCO2, less sensitive to PO2 and H+ and pulmonary mechanical receptors)
ventrolateral tract actiated by respiratory centers in the pons and medulla
how does PTH regulate Ca++ reabsorption
acts on TAL and DT to increase Ca++ resorption by increasing primary active Ca++ transporter on the basolateral membrane
gastric peristalsis/trituration functions
acts to mix and breakdown gastric components (triturate and retropulsion) regulates gastric emptying peristaltic wave forces chyme through pyloric sphincter which causes the sphincter to contract and reduce volume released into the small intestine
how does PT test work to test the extrinsic pathway
add thromboplastin and calcium to centritrufuged blood plasma and measure clotting time
myosin light chain kinase
adds phosphate and begins contraction in smooth muscle
Where are beta 3 receptors located
adipose cells to increase lipolysis
what kind of blood vessel resistance in the liver?
very low resistance
what type of transport allows cells to modify the composition of the plasma membrane?
vesicular transport/bulk transport endocytosis (subtracts-vesciles remove membrane) exocytosis (adds vesicles fuse to membrane)
what begins the intrinsic pathway
vessel damage --->exposed collagen XII---->XIIa XIIa will convert XI to XIa XIa will convert IX to IXa (WITH Ca++) IXa combines with VIIIa which then converts X into Xa (WITH Ca++) Xa combined with Va will turn prothrombin into thrombin with Ca++
what is the extrinsic pathway
vessel damage and binding of tissue factor produced by cells located outside of the endothelial cells
what are the blood vessel conditions for laminar flow
vessels are straight endothelium is healthy smaller vessels
where does the symphatetic nervous system DIRECTLY act to stimulate Na+ reabsorption
via alpha receptors on tubule cells in the proximal tubule and thick ascending limb
what do interferons do???
virally infected cell secrete INF secreted INF causes uninfected cells to produce enzymes that inhibit viral replication which prevents spread of virus to neighboring cells
which is larger adrenal cortex or adrenal medulla?
adrenal cortex
adrenal medulla hormones (_________) are ________ essential for life, while adrenal cortex hormones (_______) are ________ essential for life
adrenal medulla hormones=norephinerine and epinepherine these are non essential to life adrenal cortex(corticosteroids, mineralcorticoids and sex hormones) THESE ARE ESSENTIAL FOR LIFE
what do interferons do
virally infected cells secrete this which causes uninfected cells to produce enzymes that inhibit viral replication
how do you calculate obligatory urine volume
adults must excrete 600mosmol daily you divide that number by the maximum urine concentration what needs to be excreted/maximum urine concentration=obligatory urine volume
what is the main determinant of colloid osmotic pressure
albumin plasma protein
what are the plasma proteins
albumins (main determinant of the colloid capillary pressure) globulins (antibodies) Fibrinogen(clotting proteins) others
what are the K+ sparing diuretics
aldosteorne antagonists-decrease na+ absorption and K+ secretion in the late distal and collecting tubule Na channel blocker- block ENaC and decrease K+ secretion
what hormones control tubular reabsorption
aldosterone angiotensin II antidiuretic hormone (ADH) atrial natriuetic peptide (ANP or ANF) parathyroid hormone
what are the steroid hormones, what are synthesized from. Describe theyre synthesis compared to peptide homrones
aldosterone (mineralcorticoid) cortisol (glucocortcoid) Androgens (sex homrone) these are synthesized ON DEMAND rather than being stored for release later on
what causes aldosterone escape
aldosterone increases sodium reabsorption and thus reduces excretion and ups the BV and MAP. Over time ANP and pressure natriuresis increase Na+ excretion to balance out the levels of Na+ being reabsorbed by increased aldosterone
which layer of the adrenal cortex is controlled by the renin angiotensin-aldosterone system (RAAS)
aldosterone(a mineralcorticoid) secretion from the zona gomerulosa
what hormone leads to an increase in mean arterial pressure? and what else does it lead to an increase of
aldosterone, it also raises EC fluid volume by sodium retention
pain originating in viscera or joints will ________MAP but pain originating in skin will _______ MAP
visceral or joint pain DECREASES MAP Skin pain will INCREASES MAP
what is the function of the following mucous cell secretions HCO3- mucous trefoil proteins
all of these act to maintain the gastric mucosal barrier (protect from hi lumen H+) HCO3- creates a micro climate with high pH Mucous creates a hydrophobic barrier with long chains of oligosaccharides that expand and retain water (limits diffusion of acid through the plane of gel, viscous fingering) (mucous stimualted by prostaglandins) trefoil proteins help stabilize the barrier
Na+, Ca++, Cl-, HCO3-, Glucose relative concentrations in ICF vs ECF
all of these are HIGH IN ECF LOW IN ICF
Mg+, H+, AA, K+ relative concentrations in ICF vs ECF
all of these are low in the ECF HIGH in the ICF
salt wasting nephropathies, osmotic diuretics, and loop diuretics will all do what to distal tubule flow? What will this do to K+ concentration in the ECF
all of those will increase distal tubule flow hypokalemia
How many different deiodinases? What do they all contain?
all three (D1, D2, D3) contain AA selenocysteine which has a selenium in place of sulfur which is essential for enzymatic activity
what are properties that are exhibited by membrane carriers?
allows movement via facilitated diffusion like channels but has properties of specificity saturation competition
which receptors does norepinephrine have slightly greater potency than epinephrine?
alpha 1, alpha 2 and beta 3
what receptor controls sympathetic salvia mechanisms?
alpha 1-vasoconstriction and secretion of CONCENTRATED saliva beta 1- stimulate secretion of prot
ptyalin=
alpha amylase part of serous saliva
what must happen in order for relaxation of the skeletal muscle to occur
alpha motor neuron must stop firing cytosolc calcium concentration must decrease Calcium ATPases on SR remove calcium from cytosol Tropomysin moves and covers actin myosin binding site Actin slowly slides back to its original resting place and the sacromere returns to its
what is the difference between the alpha motor neuron and the gamma motor neuron
alpha motor neuron=in the extrafusal fibers, causes skeletal muscle fibers to contract, releases Ach and causes contraction gamma motor neuron=the efferent neuron that causes contraction of the intrafusal fibers to mimic the EF fibers
alpha intercalated cells secrete and reabsorb beta intercalated cells secrete and reabsorb
alpha- K+ and HCO3- reabsorbtion, H+ secretion beta- K+ and HCO3- secretion, H+ reabsorbtion
what are the SNS receptors and actions for salivary glands?
alpha1 vasoconstriction
what enzyme normally inactivates elastase before it can destroy elastic fibers and lead to emphysema
alpha1-anti-trypsin
give general classifications of sensory fibers from fastest to slowest
alpha=fastest Beta Gamma Delta C fibers (unmyelinated)=slowest
cobalamin=
vitamin B12
brush border hydrolases are used where and result in what end products from protein and carb digestion in the SI
amino acids and di- and trippeptides, glucose, galactose, fructose mucusol surface is where this occurs and it is the 2nd stage of protein and carb digestion in the SI, 1st stage is intraluminal by pancreatic hydrolases
what are the end products produced at the mucosal surface of the small intestine by the brush border hydrolases?
amino acids, di and tri peptides, glucose, galactose, fructose
urine volume is determined by what two factors
amount of solute to be excreted (obligatory volume) Concentration of ADH in plasma
sialorrhea (drooling) can occur with what class of drugs?
ampitriptyline(Elavil) tricyclic antidepressants
what part of the brain can produce rage, escape, punishment, severe pain and fear? produces responses through activation of the hypothalamus to change BP, GI motility, defecation, mictruition, pupillary dilation its a part oft he limbic system
amygdala
what are the two parts of the limbic system
amygdala and hippocampus
pancreatic amylase breaks starch and glycogen into _________ which is then further broken down into _________ by brush border hydrolases
amylase in the lumen breaks starch and glycogen into maltose and maltotriose these are broken down into monosaccharides by brush border hydrolases
what is the medial lemniscus
an acending bundle of heavily myelinated axons that cross over in the medulla. SUPER FAST its part of the dorsal column pathway (mechanoreceptors-touch, pressure, vibration)
what can increase pulmonary blood volume
volume increaes during inspiration lying down increases the blood volume disease states can increase volume
The volume of water in the intracellular vs. extracellular spaces is ________ but the The osmolarity of the extracellular and intracellular spaces is _______.
volume of h2o is unequal but osmolarity is equal
physiologic dead space=
anatomic dead space + alveolar dead space
what is physiologic dead space
anatomic dead space + alveolar dead space alveolar dead space usually not present unless there is a higher V/Q ratio due to low cardiac output
zona reticularis secretes
androgens
describe the Renin-Angiotensin system
angionsinogen created in liver renin created by JGA cells in kidney renin cleaves angiotensinogen into angiotensin I which is then converted into angiotensin II via ACE angiotensin II causes systemic vasoconstriction and Na+ and H20 retention to increase BP
what hormone increases H+ secretion and NaCl and H2O reabsorption in the PT, TAL, DT and CD
angiotensin II
Which arteriole does Angiotensin II act on and what does it do?
angiotensin II acts on the EFFERENT ARTERIOLE vasoconstriction here increases resistance (flow out is decreased) angiotensin II DOES NOTTTTT act on the afferent arteriole
what are the five regions of the olfactory cortex that tufted cells project to?
anterior olfactory nucleus and olfactory tubercle
what 5 regions do mitral cells project two
anterior olfactory nucleus, olfactory tubercle piriform cortex and parts of the amygdala and entrohinal cortex
what are the five regions of the olfactory cortex that Mitral cells project to?
anterior olfactory nucleus, olfactory tubercle, piriform cortex, and parts of the amygdala and entorhinal cortex.
Adenohypophysis=
anterior pituitary
which pituitary gland is a TRUE endocrine gland?
anterior pituitary
why does GH excess cause diabetes
anti insulin action of GH results in increased blood glucose levels and increased insulin secretion insulin resistance occurs
what is Rho-gam used for
anti-Rh antibodies are given to a Rh- mother who is birthing HER FIRST Rh+ baby to prevent erythroblastosis fetalis by binding to the Rh antigen on the babys RBCs and preventing it from being detected in mothers immune system
GH has _______ insulin action which results in what response?
anti-insulin action results in a decreased uptake of glucose which subsequently leads to increased hepatic glucose production and increased insulin secretion (diabetogenic)
what does asprin do to clotting at low doses
anticoagulant inhibits thromboxane A2 by platelets but NOT prostacylcin
what is an antigen? what is an epitope
antigen is a peptide or polysaccharide that are part of a molecule on an organism epitope is the molecular group on the antigen that is recognized by the immune system
agglutinogens=
antigens proteins capble of inducing an immune response
the caudad portion of the stomach consists of ______ and produces what secrettions
antrum mixing and grinding secretes mucus, pepsinogen and gastrin
what things can increase surfactant production
any thing that causes hyperinflation of the lugns sighing, yawning, exercise and beta adrenergic agonists
the apical side is towards the ________ and the basolateral side is towards the _______
apical-lumenal side basolateral- basement membrane
what is the actin orientaiton in smooth muscle
arranged diagonally to long axis of the cell
what factors influence glomerular hydrostatic pressure (primary control point for GFR)
arterial pressure(effect is buffered by autoregulation) afferent arteriolar resistance efferent arteriolar resistance
myogenic autoregulation is a function of what blood vessel?
arterioles!!!!!!
where does decreased blood volume negatively feedback to to prevent further ANP release
artria of the heart
artrial fibrillation is a ______ node problem while bradycardia is a ______ problem
artrial fibrillation is a AV node problem (irregular discharge) bradycardia is a SA node problem
when Na+ is reabsorbed what happens to H2O, Cl- and urea. Describe change charges in lumen
as Na+ is reabsorbed it creates a gradient for H2O reabsorption via osmosis and it makes the lumen more negatively charged H2O osmosis drags along other solvents which increases luminal Cl- and luminal urea concentrations this increase in Cl- and Urea concentration creates a gradient that allows for passive reabsorption of Cl- and Urea also the more negatively charged lumen also drives Cl- away
when does filtrate become hyposmotic (more dilute)
as it passes through the Thick ascending limb and early distal tubule
where does lateral inhibition occur?
at each synapse of the 3 neurons in the pathway medulla thalamus cerebral cortex
when is extraalveolar vessel resistance increased what about alveolar vessels
at low lung volumes extraalevolar resistance is increased at high lung volumes alveolar vesselss have the highest resistance, extralveolar has lower resistance
what happens in atrial fibrillation
atria fast beat AV node discharges at irregular intervals and the ventricles also beat at a completely irregular rate
what will decreae aldosterone secretion
atrial natriuretic factor (ANF) increased Na+ concentration (high Osm) changes associated with high Na+ or high BP
what is alpha actinin
attaches actin to dense bodies (intracellula and membrane bound) in smooth muscle
hashimotos thyroiditis?
autoimmune reaction against thyroid gland that causes hypothyroidism first sign is thyroiditis followed by fibrosis
what is the efferent pathway in the baroreceptor reflex
autonomic motor neurons
varicosisities are what
autonomic neuron axons that release NT into intersitial fluid to control smooth muscle release of NT from varicosity can STIMULATE OR INHIBIT CONTRACTION
what is mean arterial pressre
avergae driving pressure in systemic arteries diastolic P + 1/3(systolic P - diastolic P)
what type of synapses are responsible for presynaptic inhibition and facilitation?
axoaxonal
where does the transition from a graded potential(EPSP) to an action potential occur in a neuron?
axon hillock
what are the cell types of acquired immunity
b-cells and t-cells
what are the three stages of deglutitiion (swallowing)
voluntary-initiate swallowing process, bolus moved into pharynx by tongue, tmulates epithelial swallowing receptor area pharyneal stage-involuntary, soft palate pulled upward to close of nasopharynx, epiglottis closes of trachea for 2 secs , upper esophageal spincter relaxes esophageal stage, coordinated muscle contractions to move bolus thorugh esophagus into stomach (aborally)
what happens to undigested carbs in the colon
bacteria ferment them into short chain fatty acids which are soluble and easily absorbed salvage of nutrients
in pulmonary capillaries the band 3 protein does _________ and H2CO3 is converted to ________ via carbonic annyhrase
band 3 protein brings in HCO3- (bicarbonate which combines with H+ to form H2CO3 which is then converted to CO2 this results in more movement of CO2 into the alveolus and decreases PaCO2
what are the rapid(12-24 hrs) compensatory mechanisms for hemorrhage (2 things)
baroreceptor reflex (returns MAP to normal by increases CO and TPR) Autotransfusion-movement of interstitial fluid into capillaries, arteriolar constriction(decreased Pc) and net absorption of fluid into capillaries
what are the most slow receptors to adapt
baroreceptors pain receptors are also slow
aldosterone increases synthesis and activity of the Na/K ATPAse pump on the ________ side of the membrane and increasese synthesis of the Na+ pump and acitivty of the K+ channel on the _________ side of the membrane in the DT and CD
basolateral-Na+/K+ ATPase, pumps Na+ out into the interstitial fluid Apical- increased Na+ pump and activity of K+ channel
what does aldosterone do on the basolateral side of the membrane in the DT and CD? what about the luminal (apical side)?
basolateral-increases synthesis and activity of the Na/K ATPase pump apical(luminal side)-increases synthesis of Na+ channel and activity of K+ channel (luminal side of the cell membrane)
Hyposmotic=
bathing solution Osm < cytosolic Osm(inside)
Hyperosmotic=
bathing solution Osm > cytosolic Osm(inside)
why do RBCs clump together during an antibody response
because BOTH the antigens and antibodies have multiple binding sites
why do K+ channels cause hyperpolarization?
because EK+ is -94mV and resting membrane potentials are more positive (-70mV) K+ channels let K+ FLOW OUT of the cell to make it more negative (closer to -94mV)
Why does Erythoblastosis Fetalis only occur with the Rh antigen
because Rh antibodies are IgG which means they can cross the placenta will A and B antibodies (IgM) cannot cross the placenta
why would you give a b-beta blocker to a patient with hyperthyroidism
because T3/T4 increases the amount of B-adrenergic receptors and increases cardiovascular output with an excess
why would a drop in ECF volume cause an increase in H+ secretion and HCO3- reabsorption
because a drop in ECF volume leads to increased ANG II and aldosterone which both increase H+ secretion and HCO3- reabsorption ANG II DIRECTLY increases activity of the Na+/H+ antiporter which increases H+ secretion whilst increases Na+ reabsorbtion
why is ventricular diastole not the same as arteriole diastole? Why is this good
because elastic recoil (contraction of arteries) increases the pressure of systemic diastole this is the main driving force for MAP
Why doesnt vitamin B12(cobalamin) bind instrinsic factor in the stomach?
because intrinisc factor cannot interact with B12 at low pH. B12 binds R-binding protein in the stomach instead
why is citrate added to PT and PTT assays
because it binds calcium which prevents clotting
why does hemoglobin F(fetal hemoglobin) have a higher affinity for oxygen
because it doesnt contain the beta chain that binds to 2,3 BPG
GFR is high because ___________
because of high hydrostatic pressure and high Kf
why can DLCO2 not be calculate, what can help calculate it
because of rapid diffusion occuing in the lungs CO can help calculate
why are cardiac muscle contractions graded while skeletal muscle contractions are not
because skeletal muscle has saturation of troponin in a single AP and contraction strength is maximal in cardiac muscle one AP in resting state DOES not saturate troponin you can adjust strength of contraction by increasing Ca+ entry
what allows platelets to stick to damaged endothelial tissue and what does this stimulate production of
von willebrand factor stimulates production of Thromboaxane A2 from platelet plasma membrane
why is there a transport maximum in the renal tubules. IN other words why can 100% of all filtered substances not always be reabsorbed completely
because there is saturation of transport proteins with high blood levels of substances like glucose, amino acids, phosphate, sulfate, urate (creatine, PAH)
why does inhibiting the activity of any one factor (gastrin, histamine, etc) pharmacologically GREALY reduce acid secretion in oxyntic (parietal cells)
because these factors work synergistically to create greater level of acid secretion than just additively
why do capillaries have the slowest flow velocity?
because they have the highest surface area
when is 80% of the blood for contraction loaded into the ventricles?
between beats , period of passive filling
when is atrial pressure greater than ventriclular? what does this mean for AV valves
between beats of the heart (passive filling) AND during atrial systole (active filling) AV valves are open note: between beats the atria have less pressure than the veins and during systole they have more pressure
where are the lung irritant receptors located
between epithelial cells in the conducting zone
what transports CO2 in blood, and give from most to least
bicarbonate HCO3- (70%) carboamino-hemoglobin(23%) dissolved
what is the most powerful buffer system in the body
bicarbonate buffer system CO2+H2O <--> H2CO3 <-->H+ + HCO3-
ionic composition of pancreatic juice at high secretion rate
bicarbonate concentration is high chloride composition is low Na+ and K+ always isotonic
ionic composition of pancreatic juice at low secretion rates
bicarbonate concentration is low chloride concentration is high Na+ and K+ ALWAYS isotonic no matter the flow rate
what are the functions of bile
bile salt(acids) and lecithin are required for digestion and absorption of fat excretion of lipophilic metabolites(bilirubin), excess cholesterol, waste, drugs, toxins
what do hepatocytes secrete
bile salts, cholesterol, lecithin, bilirubin and other lipophilic substances
how do epinephrine and norepinephrine work to increase HR
bind to B1 receptors that activate cAMP second messengers that increase the time that V-gated Ca2+ channels are open and increase Ca2+ entry from ECF Also activates phospholamban which increases the activity of Ca2+ ATPase on SR, this allows for increased Ca2+ stores and Ca2+ is removed faster, this causes more forceful contractions and shorter duration of contraction
bile sequestrants bind the __________ to prevent bile acid recycling
bind to the bile salts to prevent their uptake by the ABST channels
what are the mechanisms of ADH on renal tubules
binds to V2 receptors in the late distal tubule and collecting duct which causes Aquaporin-2 insertion in the apical membrane of tubular epithelial cells allowing for water reabsorption(along with AQP-3 and AQP-4 on the basolateral membrane)
what do proton pump inhibitors (purple pill) do exactly?
binds to and inhibits the H+-K+ pump in parietal cells can cause precious anemia due to lack of B12 absoprtion
what does Heparin do
binds to antithrombin III and increases its activity by 100-1000x
what are calciums actions on smooth muscle
binds to calmodulin removes calponin (inhibits myosin ATPase) removes caldesmon (inhibits mysosin/actin bond)
What taste receptors are in the colon and what do they do?>
bitter receptors in colon induce osmotic gradient and cause diarrhea
what taste receptors are in the stomach and what do they do?
bitter receptors in stomach may stimulate CCK and emesis
which taste gas the highest number of receptors and LOWEST threshold for perception
bitter taste its protective
chronic use of NSAIDs might cause
bleeding problems because of lack of thromboxane
Alpha 2 receptors act to
block further NE release (presynaptic receptor), they stimulate lipolysis (Gi protein, and decreased cAMP signaling)
what does Dabigatrin etexilate do
blocks active site of thrombin
plavix (clopidogrel) does
blocks platelet activation
what does clopidogrel (plavix) do
blocks platelet activation
dabigatrin etexilate does what?
blocks thrombin active site
what does warfarin do
blocks vitamin K.... no clotting factor synthesis
what can decrease CO
blood loss, heart diosease
what is the MOST important factor in determining blood vessel resistance, MAIN CONTRIBUTOR
blood vessel radius R=8nl/pir^4 r is to the 4th power thus it is far more important in determining resistance
what is vascular shock
blood volume is noormal but circulation is poor due to abnormal expansion of the vascular bed caused by extreme vasodilation. Huge drop in TPR results in MAP drop
what is the difference between acromegaly and gigantism
both are GH excess problems but Gigantism=in childern Acromegaly=in adults
what are similarities of cardiac and skeletal muscle in function
both have sarcomeres as the functional unit both have similar length and tension
how do cholera and e. coli cause diarrhea?
both produce enterotoxins that stimulate small intestine crypt cells to increase cAMP. Increased cAMP activates Cl- secretion into gut lumen on apical side via CFTR Na+ and H2O follow Cl- out thus spewing diarrhea occurs
what is included in the A band
both thick and thin filaments
if you increase CO or TPR what will that do to MAP?
both will increase MAP MAP=CO x TPR
what are the components of the renal corpuscle
bowmans capsule (parietal and visceral layers) glomerular capillaries (glomerulus bowmans spaces
describe relative osmolarity in the following Bowmans capsule End of proximal tubule End of loop of Henle End of collecting duct
bowmans- 300 mOsM End of Proximal Tubule is 300 mOsM (isoosmotic reabsorption occurs here) End of Loop of Henle is 100 mOsM (reabsorbtion of ions without H2O means the solution becomes hypoosmotic) End of Collecting Duct (variable depending on ADH) 50-1200 mOsM
ATP binding of myosin does what?
breaks the crossbridge of actin an myosin during binding of the myosin head energy released from ATP hydrolysis on the myosin head returns the myosin head to its high energy start
how are fats absorbed in the small intestine
broken down by pancreatic lipase into FA and MG and then packaged into micelles then unpacked at brush border and cross apical membrane via simple diffusion in the SMOOTH ER the TG is resynthesized to keep FA and MG low inside the cell TG and other hydrophobic substances are packaged into chylomicrons and secreted across the BL membrane via exocytosis chylomicrons enter lacteals (lymphatics) before going to venous circulation
polysaccharides and disaccharides (carbs) are digested and broken down into what before they can be absorbed?
broken down into glucose, fructose and galactose before it can be absorbed fiber (cellulose) cannot be digested
what 3 things control radius of bronchi and bronchioles
bronchodilation bronchoconstriction mucus acculumation
what enzyme is involved in protein digestion on the brush border of small intestin
brush border peptidases produce amino acids
what is a diverticula and what causes it
bubbles in the wall of the colon caused by excessive pressure forces trying to move HARD immovable shit out
what saliva glands have mucous secretion only
buccal glands
what are compensation mechanisms for metabolic acidosis
buffer of body renal compensation (assuming this isnt the problem) respiratory compensation (increase in Va, to decrease CO2 which decreases H+)
what compensation would the body have for respiratory alkalosis
buffer of body renal compensation (increased HCO3- excretion, decreased H+ excretion, decreased glutamine metabolism and NH4+)
what are the compensation mechanisms of respiratory acidosis
buffers of the body and renal compensation(reabsorb all filtered HCO3-, secrete excess H+ and add new HCO3- to ECF(increased glutamine metabolism and NH4+ excretion))
what will cause increased capillary permeability and thus edema
burn and inflammation
how can cardiac muscle contraction strength be adjusted
by altering amount of Ca++ entry through L-Type Ca++ channel in the plasma membrane
how do you control cardiac output
by changing stroke volume (SV) and heart rate (HR) CO=SVxHR
how do individual target cells alter their response to T3
by controlling deiodinase synthesis
how can you gauge the complexity of a reflex pathway?
by looking at the speed of the reflex (number of synapses will determine this)
hypothyroidism symptoms
weight gain coarse, dry, brittle hair loss of lateral eyebrows lethargy and impaired memory periorbital edema deep course voice cold intolerance slow pulse gastric atrophy constipation muscle weakness peripheral edema
high fiber meals are beneficial for ?
weight loss and speeding bowel movements
Substania Nigra Compacta
what area of the brain has neurons that project to the basal nuclei and releases dopamine. This area is affected during parkinsons disease
what is the alkaline tide?
when acid is secreted by parietal cells there is movement of HCO3- out of the parietal cell into the blood while Cl- moves in due to carbonic anyhrydrase reaction. H+ and Cl- (HCl) get pumped into the lumen
when alpha motor neurons are activated what must be true of gamma motor neurons
when the alpha neuron is activated the gamma motor neuron will also be activated
what is the optimal length?
where there is best degree of overlap between the thick and thin filaments At optimal length the GREATEST number of actin/myosin cross-bridges can form which rsults to produce maximal tension
both channels and carriers allow for facilitated diffusion across a membrane channel what is a difference between the two in terms of properties
while both can have specificity Only carriers have properties of saturation and competition
what happens to MAP with arterioscleosis
with low artery elasticity you will have decreased diastolic pressure which will decrease MAP without elastic recoil of aorta you will have decreased diastolic pressure
what removes ca from the cytosol during relaxation of a skeletal muscle
calcium ATPases on the SR remove calcium from cytsol and tropomyosins shape changes and blocks the binding site for actin
what are the requirements for smooth muscle contraction
calcium-binds to calmodulin and removes calponin and caldesmon from actin ATP Myosin Light Chain phosphorylation-required for myosin head to interact with actin
what are the two actin binding proteins in smooth muscle
calponin caldesmon
what are the two actin binding prots in smooth muscle
calponin-inhibits myosin ATPase Caldesmon ihibits myosin/actin bond
what can Forced Vital Capacity and Forced Expiration Volume be used to test for?
can be used to test for increased airway resistance
Veins are highly distensible so they are _________vessels that act as _________
capacitance vessels that act as blood reservoirs 60% of TBV
what are the three layers of the filtration barrier
capillary endothelium (fenestrated) basal lamina (basement membrane) podocytes (visceral layer of bowmans capsule ) negatively charged
what are the filtration forces in the pulmonary capillaries
capillary pressure Pc Intersitial fluid pressure (this is -8mmHg) intersitial colloid osmotic pressure (this is higher than in systemic)
what is the glycocalyx
carbohydrate layer attacted to the EC surface of membrane lipids and proteins plays important role in enabling cells to identify and interact with each
where do the following diuretics work.... carbonic anhydrase inhibitors loop diuretics thiazides K+ sparing osmotic diuretics ADH antagonists
carbonic anhydrase inhibitors-PCT loop diuretics -TAL thiazides -early distal tubule, Na+/Cl- cotransporter inhibited K+ sparing-late distal and collecting tubule osmotic diuretics-everywhere? ADH antagonists-DT/CCD
what is absorbed fastest in the stomach?
carbs proteins and fats will slow everything down
what are the effectors in the baroreceptor reflex pathway
cardiac muscle (AR and contractile cells), arteriorlar smooth muscle, venous smooth muscle
As H20 moves via osmosis in the renal tubules what else happens
carries other solvents along (solvent drag, size restricted) creates gradients for the passive reabsorption of other solutes like Cl- and Urea
what does the completement system
cascade of reactions that lead to.... enhancement of inflammation opsonization of pathogens formation of a membrane attack complex and lyses pathogens
increases of only 3-4 mEq/L of K+ in the ECF can
cause cardiac arrhythmias cardiac arrest or fibrillation
what are the mechanisms of ADH on blood vessels
causes contraction of vascular smooth muscle via V1 receptors
what happens in prolonged hypertension
causes heart failure, renal failure, stroke, and vascular disease
what does an activated T-Cell do
cell mediated immunity activation via (natural killer and cytotoxic T CD8 cells) humoral immunity(antibody mediated)-activation of B cells which develop in to plasma cells that secrete immunoglobulins, these enhance phagocytoissi via oponsization
what is the difference between humoral and cell mediated acquired immunity
cell mediated is via CD8 and NK cells-kill shittttt that dont belong humoral(antibody mediated)- activated B cells develop into plasma cells that secrete immunoglobulins antibodies neutralize toxins and viruses and enhancing phagocytosis via oponsization
what makes 45% of whole blood
cellular elements blood cells
describe smooth muscle anatomy(she said she wont test on this)
cellular shape is elongated and tapered it is non striated and it lacks T-tubules and only has a rudimentary SR
what structures are found in the midbrain
centers for motor control (substantia nigra, red nucleus and superior and inferior colliculi nuclei of the reticular formation periaqueductal gray region
what is central tolerance? what about peripheral
central tolerance is clonal deletion in fetal thymus and bone marrow peripheral tolerance is clonal anergy, when cells that are self antigenic become non functional
which phase stimuli will increase ENS stimulation of G-cells, ECL cells, and parietal (oxyntic) cells
cephalic phase stimuli (parasympathetics via vagus) gastric phase stimuli(distension, amino acids, peptides) increases G-Cells secretion of gastrin which increases ECL and parietal cells indirectily
cephalic phase and gastric phase stimulate will result ________ acid secretion and the intestinal phase will result in ________
cephalic(food stimuli brain) and gastric(food in stomach) will stimulate Acid release intestinal phase will inhibit via enterogastrone release and inhibition of the ENS
what are the three parts of the cerebellum
cerebrocerebellum (lateral zones)-planning and timing of sequential movement Spinocerebellum(vermis)- Receives sensory input from proprioceptors and coordinates movements distal limbs (hands, fingers) Vestibulocerebellum(flocculonodular lobes)-controls balance between agonist/antagonist muscle groups when rapids changes are needed
What are theories for fatigue
change in membrane potential decreased ACH blockage of blood flow central fatigue increased metabolic byproducts depleted glycogen
what might indirectly alter the affect the plasma hormone levels of thyroid hormones and steroid hormones. Why?
changes in liver function LIVER produces MOST binding proteins
changes to blood volume will first have what effect?
changes to venous pressure which will increase or decrease venous return and EDV ultimately impacts SV and CO and MAP
thrombocytopenia=
characterized by a lack of platelets, causes spotaneous bleeding
Chest wall has ______recoil but lung has _____ recoil
chest wall- outward recoil lung- inward recoil
what cells secrete PTH
chief cells of parathyroid gland
bile salts are produced from
cholesterol
what are all adrenal cortex hormones made from?
cholesterol
what is the rate limiting step of all the adrenal cortex hormones being produced? converts cholesterol to the first precursor
cholesterol desmolase
what enzyme breaks down cholesterol esters? What enzyme breaks down phospholipids? Where are both of their end products packaged?
cholesterol ester hydrolase (luminal) Phospholipase A2 (luminal) breakdown products packaged into micelles along with the triglyceride digestion products
chronotropic agents affect ______ while iontropic agents affect?
chronotropic=heart rate ionotropic=contractility of heart
what features help to increase surface area for absorption in the lumen of the GI tract?
circular folds villi microvilli (brush border)
desribe the components of the muscularis externa
circular muscle (contraction narrows lumen) longitudinal muscle (shortens tube) myenteric plexus(network of neurons with input from ANS and projections to the submucosal plexus and both muscles)
regular ventricular depolarizations due to a _______ involving the ventricle
circus movement
cirrhosis produces _______ while increased vascular resistance ______
cirrhosis increases resistance causes portal hypertension increased vascular resistance can cause ascites
Renin release following decreased MAP (with no change in ECF volume or osmolarity) will result in
cleavage of angiotensinogen into ANG I, ANG I converted to ANG II via ACE. ANG II acts on 4 things 1. arterioles-vasoconstriction 2.CV control center in medulla-increase CO 3. hypothalamus-increase thirst and ADH 4. adrenal cortex- aldosterone release--->increase Na+ reabsorption
What causes first heart sound? what about second?
closing of AV valves=first closing of semi lunar valves=second
what are two factors other than a decrease in ECF osmolarity, increase in blood pressure or increase in blood volume that would cause decreased ADH secretion
cold ethanol (alcohol)
what do we have more receptors for, hot or cold?
cold 3-10 times as many
all formed elements (myeloid and lymphoid) are produced from a _____
common pluripotent hematopoietic stem cell
gap junctions allow _______
communication via ion transfer
what things can IgG do?
complement activation opsonization of bacteria neutralizes bacterial toxins and viruses antibody dependent cell mediated cytoxicity mediated by NK cells and macrophages CROSS THE PLACENTA
exposed Fc portion following antigen binding by antibody promotes?
complement fixation opsonization activation of NK cells
Antigens bound with an exposed Fc site will lead to what stuff (3 things)(
complement fixation opsonization(Fc binds to receptors on phagocytic cells) activation of NK cells
what is a third degree heart block
complete no QRS complex
humoral immunity=
component of aquired immunity where activated B-cells develop into plasma cells which produce immunoglobins(antibodies)
during inspiration hat happen to alveolar vessels what about extra-alveolar vessels
compressed and elongated and their resistance INCREASES extra-alveolar vessels have decreased resistance
what does ADH do to urea in the nephron
concentrates urea in filtrate through water reabsorbtion in cortical and medullary collecting ducts activates carriers for facilitated diffusion of urea by medullary collecting duct cells this allows for secretion into the descending limb and thin ascending limb of loop of henle
Alpha 1 receptors act to
constrict smooth muscle (through Gq protein, and increased IP3 signaling)
what are the arteriolar changes necessary to decrease GFR (via decreased hydrostatic Pg)
constrict the afferent arteriole (incoming) or dilate the efferent arteriole (outgoing)
what are the arteriolar changes necessary to increase GFR (via increased hydrostatic pressure Pg)
constrict the efferent arteriole or dilate the afferent arteriole
what would angiotensin II do to the following Pc Pg Colloid osmotic pressure of the peritubular capillaries
constriction of the efferent arterioles will decrease Pc in peritubular capillaries increase colloid osmotic peritubular capillary pressure increase in Pg in glomerulus causes an increase in the filtration fraction meaning more proteins concentrated
what factors DECREASE force of antral contractions decrease gastric secretions
contents in stomach stimulating enterogastrone release CCK (fat and protein) Secretin (acid GIP (carbs)
what decreases the force of antral contractions and slow gastric emptying
contents of the duodenum increased aciditity, fat, amino acids, hypertonicicty distension----> stimulates enterogastrone hormone release like CCK(fat, protein), secretin(acid), GIP (carbs) and stimulates neural receptors via short and long reflexs to decrease gastric emptying
in high O2 are capillary spincters relaxed or contracted?
contracted
what makes up the majority of cells in the myocardium
contractile cells
what is densitization therapy
controlled injections of the antigen works by producing IgG rather than IgE IgG considered to be blcoking antibodies
Vestibulocerebellum(flocculonodular lobes)-
controls balance between agonist/antagonist muscle groups when rapids changes are needed
what is the sphincter of oddi?
controls biles and pancreatic release into the duodenum
what does thrombin do
converts fibrinogen to fibrin AND converts XIII to XIIIa which stabilizes fibrin ALSO positively feeds back to the prothrombin activator
what allows for information from one hemisphere of the brain to be available to the opposite hemisphere?
corpus callosum
Medial Midbrain (Weber) syndrome results from damage to what?
corticobulbar tracts , causes contralateral spastic hemiparesis of lower facial muscle and hypoglosssal nerve fucntions
what tract controls voluntary breathing (activated during talking, sneezing, singing, swalling, coughing, defecation, axiety, fear
corticospinal tract
the corticospinal tract contains __________ axons and the spinothalamic tract contains
corticospinal tract contains descending motor axons spinothalamic tract contains ascending sensory axons
what is the voluntary control tract for breathing
corticospinal tract(descending input from thalamus and cerebral cortex, bypasses the respiratory control centers in medulla and pons)
what three drugs can block action of lympho, mast cells chemical mediator
corticosteroids-immunosuppressats benedryl-blocks histamine receptors other drugs prevent release
in addition to PTH bone resporption is stimulated by what other hormones
cortisol and T3
21 hydroxylase controls the synthesis of what?
cortisol and aldosterone from a progesterone and 17 hydroxyprogesterone precursor
what other endocrine hormone can activate mineralcorticoid receptors (aldosterone) receptors
cortisol, excess cortisol nees
what could inhibition of deiodinase cause?
could show signs of hypothyroidism
what creates the hyperosmotic medullary intersitital fluid that is required for creating a gradient that allows for concentration of urine through increased water reabsorbtion
counter current multiplier mechansims in juxtamedullary nephrons high interstitial fluid osmolarity
what is the difference between allosteric modulation and covalent modulation of ion channels?
covalavent (strong bonds) typically involves a enzyme mediated change (kinase and phosphatase) allosteric (noncovalent, weak bonds) is when something weakly binds and changes the conformatoin
bruits and murmurs will do what to flow in blood vessels
creates turbulent flow
what two substances can be used as an index of GFR because they undergo no secretion or reabsorption Ea=Fa (excreted amount=filtered amount)
creatinine inulin
what are the C fiber(slowest sensations)
crude touch and pressure tickle aching pain cold(also some Adelta) warm(also SMALL amount of Adelta)
enterotoxins produce diarrhea by acting on what cells in the GI tract
crypt cells
what is the autosomal recessive disorder that results in defective chloride ion transport (mutation in CFTR ion channel)
cystic fibrosis
what kind of hormone receptor does leptin use?
cytokine
what can cause hemiballismus(contralateral flinging movement of one or both extremities)
damage to the subthalamus in the diencephalon
what does the sympathetic nervous system do to the renal re-absorption/secretion
decreaes Na+ and H2O excretion -constricts arterioles, stimulates renin release decreases GFR and renal blood flow DIRECTLY stimulates Na+ reabsorption via Alpha receptors on tubule epithelial cells in the PT and TAL
-ionotropic agents will _______ ejection fraction
decrease B1 blockers and Ca++ channel blockers
lowering artery elasticity will _______ MAP
decrease MAP you decrease diastolic pressure (the biggest influencer on MAP) by reducing the elastic recoil of aorta
restrictive lung disease (pulmonary fibrosis) will ______ compliance which means
decrease compliance will breathe shallow and fast to reduce work of breathing
a decrease in MAP will cause a ________ in AP firing rate to the brainstem and cause ______
decrease in AP firing(less strech) which will increase sympathetics to the heart, arteries and veins decreases parasympathetic
what are the 3 major mechanisms of polyuria
decrease in Na+ reabsorption (kidney disease, diuretics) reduced adh secretion (hypothalamic or central DI) ADH resistance(nephrogenic DI)- lithium and tetracylines, hypercalcemic nephrogenic DI
Elastic recoil of the lungs favors a ______________
decrease in lung volume and compression used for expiration
increasing HR will do what to SV
decrease stroke volume BUT remember that HR has a greater affect on CO unless extreme tachycardia happens
CCK, secretin and GIP do what to the force of antral contractions (gastric emptying)
decrease the force decrease gastric emptying
too much binding proteins in the plasma could do what to hormone functions.
decrease the hormones ability to function because only the free form can cause a response
NO and Prostacylin will
decrease tone and relax smooth muscle
Bradykinin will do what to renal arterioles and what effect to RBF and GFR
decreased AFFERENT arteriole resistance which increases RBF and increases GFR
what would happen in response to a drop in MAP with no change in blood volume or osmolarity (anaphaylatic shock)
decreased BP--->lowered GFR---> decreased NaCl to macula densa---> macula densa stimulates renin release from granular cells of afferent arteriole also the cardiovascular center increases sympathetic activity which directly acts on the granular cells causing them to secrete renin
decreased GFR will cause what TGF response
decreased GFR means decreased rate of filtrate flow in nephron this means increased Na+/Cl- reabsorption and decreased Na+/Cl- delivery to MD which is sensed by the MD (Na+/K+/2Cl-)and signals are sent to the JG cells to increase renin secretion and thus increase ANG II production this increases efferent arteriole resistance and decreases afferent arteriole resistance which increases the hydrostatic pressure and increases GFR
describe H+, HCO3- and CO2 concentrations in respiratory alkalosis
decreased H+ decreased HCO3-(renal compensation, less reabsorption) decreased CO2 (primary abnormality)
describe H+, HCO3- and CO2 concentrations in metabolic alkalosis
decreased H+, increased HCO3-(primary abnormality) , increased CO2 (from reflex of respiratory system decreasing ventilation of CO2)
what will decreased ECF osmolarity do to K+ concentration in the ECF
decreased K+ concentration moves K+ into cells
what are the PHYSICAL factors that decrease GFR
decreased Kf (permeability) increased Pb (increased bowmans hydrostatic pressure) increased colloid osmotic pressure of the capillary decreased capillary hydrostatic pressure
what will decrease Pg? what will this do?
decreased MAP BELOW 80 mmHg Increased sympathetics activity(vasoconstrictions) acting on the afferent arteriole (lowers incoming flow, thus lowering pressure) decreased angiotensin II (ACE inhibitor) decreases resistance in the efferent arteriole (allows more fluid out, decreases pressure)
describe how the macula densa responds to decreased Na+ in filtrate
decreased Na+ in filtrate means that more reabsorption is occurring due to decreased GFR macula densa responds by paracrine signaling to JG(granular cells) to get them to secrete renin which will get converted to ANGII which will increase efferent arteriole resistance and decrease afferent resistance to increase GFR
what vitamins and ions would have decreased absorption if a patient was using a proton pump inhibitor?
decreased absorption B12, iron and calcium
what reflex stimuli will increase MAP
decreased arterial O2 increased arterial CO2 Decreased brain blood flow pain originating in skin stress anger eating sexual activity
what is the mechanism for autotransfusion
decreased arterial pressure --->arteriole constriction which reduces Pc and increases fluid absorption from intertitial compartment to raise plasma volume and restore blood pressure
what are the stimuli for ADH secretion
decreased blood volume (isotonic) increased osmolarity(isovolumic) Decreased blood pressure
what happens to blood pressure with hemorrphage
decreased blood volume decreases venous pressure and decreases venous return decreases artial pressure and Ventricular end-diastolic volume this decreases stroke volume and cardiac output this decreases blood pressure
hypoxic drive is ________ by nitrous oxide
decreased by nitrous oxide
more collagen fibers (scar tissue) in lung would to ______ compliance
decreased compliance, less elasticity
what two things cause pulsation of pressure to stop in the capillaries
decreased elastic collagen tissue(more compliance) and increased (resistance) =more damping damping=a (R)x(Compliance)
hyperkalemia (>6mM) does what to Vm
decreased excitability Depolarizes Vm too much and causes inactivation gates of the V-gated Na+ channels to close
Why does acidosis cause hyperkalemia?
decreased intracellular pH inhibts K+ uptake by cell and increases extracellular concentrations
what physiologic/physiological cause the following physical factors that DECREASE GFR decreased Kf increased Pb increased colloid osmotic pressure of capillary
decreased kf from renal disease, diabetes mellitus, hypertension urinary tract obstructino increased proteins and dehydration
what is von willebrands disease
decreased levels of von willebrand factor which decreases platelet plug formation
Decreased ECF osmolarity does what to ADH release (be specfic) Decreased Plasma Volume Does what? which one is ADH more sensitive to?
decreased osmolarity (more h2O)--->detected by hypothalamic osmoreceptors--->ADH release INHIBITED Decreased plasma volume leads to decreased venous,. artial and arterial pressure is detected by cardiovascular baroreceptors and they stimulate ADH release from post pit ADH secretion is more sensitive to changes in osmolarity
what factors decrease ADH secretion
decreased plasma osmolarity increased BP (directly via baroreceptor) increased blood volume (via increased ANP release) ethanol cold
what will cause decreased colloid osmotic pressure of the capillaries
decreased plasma protein concentration (liver failure) protein malnutrition nephrotic syndrome (loss of proteins)
NO will do what to renal arterioles and what effect on RBF and GFR
decreased resistance in afferent arteriole and efferent arteriole
what does sleep, opoids, chronic obstruction and deep anesthesia do to responsiveness of respiratory system to increased PaCO2 levels
decreased response thresholds decreased and slope of response
what will extremely high HR (tachycardia) do to VR
decreasees CO and decreases EDV
what will cold and alcohol do to ADH secretion
decreases ADH secretion
what are calcitonins actions in the kidney?
decreases BOTH phosphate and calciums reabsorption INCREASES excretion
what will increased sympathetic output do to GFR
decreases GFR
describe sympathetic activity on Na+ levels in renal tubules
decreases GFR and renal blood flow-->indirectly increases Na+ reabsorption increases Renin---> Ang II--->Aldosterone (and ADH) Ang II directly acts to increase Na+ reabsorption in the PT, TAL, early DT and aldosterone increases Na+ reabsorption in the late DT and collecting duct DIRECTLY acts on alpha receptors in the PT and TAL to increase Na+ reabsorption
when ATP binds myosin it ________ its affinity for actin and the two _______
decreases affinity the two separate
GFR will ______ across the length of a capillary because _______
decreases because the glomerular capillary colloid osmotic pressure increases along the length net filtration is acocmplished along the entire length though
high elasticity will ________ compliance
decreases compliance arteries have decreased compliance (more pressure change with less volume)
pulmonary surfactant from type II cells helps to _______ elasticity and _______ compliances
decreases elasticity and increases compliance through lowering surface tension
hypokalemia does what to Vm
decreases excitibility K+ flows out of the cell into the ECF which means hyperpolarization further from threshold
increase in intraplural pressure will cause _____
decreases in Ptp thus a decrease in lung volume
flow will ______ with increased resistance and constant pressure
decreases with increased resistance Q=F=DeltaP/R
what detects deep pressure? what detects light pressure? which one helps to localize sensation?
deep=pancician light=meissners meissners helps to localize
hypoatremia may be cause by what
dehydration-increased NaCl(diarrhea, vomiting, renal disease, diuretics, Addisons disseae (aldosterone deficiency) Overhydration-excess H2O retention, inappropriate ADH, H2O toxicity Low solute intake- decreased NaCl intake in extreme diets
how do target cells make active T3
deiodinases and iodinases remove and iodine from T4
what are oral manifestations of GH deficiency
delayed growth of skull and facial skeleton--> small facial appearance Tooth formation and growth are abnormal and may be disproportionately smaller than adjacent structures -tooth crowding and malocclusion -a high tendency for plaque acculumation -difficulting maintaining good oral hygiene -prone to gingivitis and periodontal disease
what is the relative concentration of glucose, proteins amino acids and phosphates in the ECF vs ICF
delete
which APC ingests antigen and then migrates to the nearest lymphoid organ
dendritic cells
all mechanisms of sour taste lead to what?
depolarization of receptor cells
why does helicobacter pylori cause stomach ulcer?
destroys gastric diffusion barrier
pacinian corpuscles detect ________ and are located in ________ and have __________ adaption
detect DEEP pressure and vibration In the subcutaneous tissue viscera and joints Have rapid adaption/phasic
free nerve endings detect _____ and are located in _______ and have _______ adaption
detect pressure and touch in the skin, cornea, dental pulp and GI tract Slow adaption/Tonic
higher frequency vibration (700 cycles/sec) is detected by which receptor and what pathway does it use?
detected by pacinian corpuscles and the dorsal column pathway
intraluminal digestion by pancreatic hydrolases results in what end products?
di and tripeptides, amino acids, maltose, maltotriose, alpha limit dextrins, glucose, fat digestion completed here
what are the inspiratory muscles
diaphragm and external intercostals
which blood pressure has a greater effect on MAP
diastolic
which pressure has the greatest influence on MAP
diastolic
most common cause of diastolic dysfunction is __________ most common cause of systolic dysfunction is __________
diastolic dysfunction-->hypertension (ventricle stiffens) Systolic dysfunction--> myocardial damage
what are the two types of heart failure
diastolic dysfunction-ventricles have reduced compliance, reduced EDV systolic dyfunction- ventricle has reduced contractility, reduced stroke volume at any given EDV
dyspnea=
difficulty breathing
elastase=
digestive enzyme for proteins in the small intestine lumin
what is the arteriovenous anastomosis
direct connection between arteriole and vein no exchange occurs here
hypokinetic disorders are caused by damage to what pathway of the basal nuclei? ie parkinsons
direct pathway damage direct is excitatory
what are the two pathways formed by the basal nuclei
direct-increases cortical excitation and promotes movement indirect- inhibits cortical activity and inhibits movement
lateral inhibition improves ________
discriimination and acuity
what is carbon dioxide transported as, which is slowest and which is fastest
dissolved CO2 Carbamino-hemoglobin-Slowest Bicarbonate (HCO3-)-fast
what does recombinant t-PA do
dissolves intravascular clots if given immediately
during the gastric phase of acid secretion what happens in response to distension and peptide release from food in the stomach
distention activates enteric neurons to release Ach and stimulate ECL and G-cells Distention and peptides DIRECTLY act on G-cells to stimulate them food in stomach buffers acid which prevent D-cells from being stimulated to secrete somatostatin
what stimulates the feeding pattern of the small intestines (BER slow waves, 3-12 waves/min)
distention of the duodenum nutrient content of chyme gastroenteric reflex (short feedback from stomach to small intestine) hormones- stimulated by CCK, Gastrin, Insulin, Serotonin
what things can stimulate secondary peristalsis?
distention or low pH in the lower esophagus
vibration is only detected by what pathway?
dorsal column
why do opiates inhubut respiration and decrease sensitivity to changes in PCO2
dorsal respiratory group has opiate receptors that inhibit respiration and decrease sensitivty to PCO2
what is the inspiratory respiratory center where does it recieve AFFERENT input from? what about its Effferent output)
dorsal respiratory group-nucleus of the tractus solitarious afferent from cranial nerve IX(chemoreceptor) and X(chemoreceptor AND mechano receptor) efferent to the phrenic motor neurons
what is the inspratory medullary center, recieves afferent input from cranial nerves IX and X. Sets ryhm for breating central pattern generator.
dorsal respiratory group-nucleus of the tractus solitarius
describe why a drop in ECF volume would cause increased H+ secretion and HCO3- reabsorption
drop in ECF volume---> ang II and aldosterone release aldosterone stimulates intercalated cells to secrete H+
what is orthostatic hypotension
drop in MAP upon standing the effects of gravity cause a decrease in VR and decrease EDV--->decreased SV and thus decreased CO and decreased MAP
without Thyroid hormone what happens to BMR
drops 50% less O2 consumption and metabolic activity
what can impair bilirubin and bile salt secretion
drugs (acetaminophen), viral hepatitis, toxins fibrosis, cirrhosis
what are the stimuli for ductal cell secretion
duct cell-->H20 and HCO3 secretion two stimuli, secretin (secretin receptor) and Ach(M3 receptors) secretin increases in response to acid in small intestine which increases bicarb secretion in pancreas
which pancreatic cells secrete bicarbonate HCO3- and h2O
duct cells
why is there a synaptic delay of at least 0.5ms between pre-synpatic depolarization and post-synaptic response?
due to time for Ca+ entry for exocytosis, release of the NT and diffusion across the synaptic cleft and postsynaptic receptor activation
why is there a larger colloid osmotic pressure in the peritubular capillaries
due to volume lost during filtration
Iron absorption in the small intestine occurs where
duodenum
where is Fe absorbed
duodenum
why would running cause contraction of the jaw closing muscles
each step causes a downward movement of the mandible in relation to the head this movement Stretches the muscle spindle which causes a reflex contraction of the jaw closing muscles
at what two stages of the cardiac cycle are all valves shut?
early ventricular systole-isovolumetric contraction=increase in ventricular pressure early ventricular diastole-isovolumetric relaxation=drop in ventricular pressure
where are alpha 1 receptors located and what is the major function
effector tissues: smooth muscle and glands Increased Ca2+ to cause contraction and secretion
what happens to efferent and afferent arteriole resistance in the TGF response to low sodium (low GFR)
efferent arteriole resistance INCREASES Afferent arteriole resistance Decreaeses ultimately INCREASES Pg pressure to INCREASE GFR
what prevents the arteriole diastolic pressure from dropping to ventricular diastole pressure
elastic recoil of aorta
electrical synapses have ______ conduction and chemical synapeses have ______ conduction
electric=bidirectional conduction chemical-one way conduction
Eion=
electrochemical equilbrium deltaE-deltaC=0 deltaE=deltaC
prandial state for surface cells absorption
electrogenic (only one positive ion moves in) anions and water follow in surface cells Na+ is absorbed with glucose via SGLT1 on apical side 3Na+/2K+ ATPase and GLUT2 transport on basolateral
what substances are secreted in the tubules
electrolytes like K+ and H+, Drugs and Toxins
the post prandial state for surface cells
electroneural H20 follows on apical Na+ and Cl- come in, H+ and HCO3- out DRA (PAT1) transport Cl-/HCO3- NHE3 Na+/H+ on basolateral 2Cl- and 3Na+ out 2Cl-/K+ symporter 3Na+/2K+ ATPase
digestion of fats requires __________ which can be accomplished through ______ and __________
emulsification Bile salts and Lecithin(phospholipid)
what are the long term compensatory mechanisms to hemorrhage
endocrine system-ANGII, aldosterone, ADH(restore volume and osmolarity) Erythropoietin-restores hematocrit behavior- thirst and consumption of H20
what cells control tone of the blood vessel through vasodilators like prostacylcin and NO and vasoconstrictors like endothelin-1
endothelial lining cells
what are paracrines and autocrines involved in local control of RBF(GFR) give function
endothelin-vasoconstrictor prostaglandins-vasodilators NO-vasodilator Bradykinin-vasodilator Dopamine-vasoconstrictor/vasodilator
what primarily controls the feeding pattern of the small intestine motility?
enteric nervous system
what do the intestinal phase stimuli (increased H+, distension, osmolarity and fats in the duodenum) do to stomach acid secretion?
enterogastrone release CCK, secretin, GLP-1, GIP ALL inhibit parietal cells, ECL cells, and G cells AND enteric neurons (ACh)
how are bile salts recycled
enterohepatic circulation active absorption by the apical sodium dependent bile salt transporter (ASBT)
what two things does the pancreas use to activate its inactive enzymes
enterokinase and tryspin enterokinase turns trypsinogen into trypsin and trypsin activates the other pancreatic enzymes
what is the A-band (dark) composed of?
entire length of thick filaments
are the are sympathetic positive iontropic agents and what is there mechanism
epi and norepinpherine bind to B1 receptors in heart these B1 receptors activate cAMP which phosphorylates V-Gated Ca2+ channels (L-type Ca2+) which increases Ca2+ the cAMP also phosphorylates phospholamban to activate it. Phospholamban increases Ca2+ ATPase activity which increases Ca2+ SR stores and removes Ca2+ faster these mean more Ca2+ can be released (more forceful contraction and it can be removed to the SR more quickly (SHORTER contraction time)
what things can cause bronchodilation
epi on B2 receptors decreased oxygen increased Co2
what things cause bronchodilation
epi on Beta 2 B2 receptors, lowered oxygen, increased CO2
what is the mechanistic explanation of epinephrine in local anesthetics
epinephrine acts on alpha 1 receptors to cause vasoconstriction which keeps the anesthetic in place locally for longer periods of time
what will activate B1 receptors and what do they do?
epinephrine from adrenal medulla (sympathetics) these will increase HR
what sympathetic chemical will cause vasoconstriction? what about dilation? what receptors?
epinephrine-CAN CAUSE BOTH VASOCONSTRICTION AND VASODILATION (Alpha and B2 receptors respectiviely) norepinephrine- can ONLY DO vaso constriction via Alpha receptors
what type of cells are taste receptor cells
epithelial
Epi &NE have almost equal potency at _____________; Epi has_______________________ at B2 receptors than NE; NE has __________________ at B3 receptors than EPI.
equal potency at B1 receptors Epi has MUCH greater potency at B2 receptors NE has slightly greater potency at B3 receptor
resistance in the pulmonary circulation is LOWEST when lung volume is __________
equal to FUNCTIONAL RESIDUAL CAPACITY (volume in lungs after a TV expirationf
low O2 levels stimulate what from kidney
erythropoietin production from kidney
what are the permeable solutes?
ethanol fatty acids O2 CO2 Steroids Urea (systemically) Glucose(systemically)
what is hemochromatosis
excess of Iron damages liver, heart, pituitary gland, pancreas and joints
what increases levels of 2,3 BPG (4 things )
exercise, hypoxia from high altitude, pregnancy and chronic lung disease.
90% of pancreas is for
exocrine secretion
what motor neurons does ventral respiratory group-nucleus ambiguus and nucleus retroambiguus innervation
expiratory muscle (abdominals, internal intercostals) accessory inspiratory muscles group of neurons in the pre-Botzinger complex that have respiratory pacemakes controls
intrinsic pathway starts with
exposure of blood to collagen which activates XIIa and ends with activation of Prothrombin Activator (Factor Va and Xa complex)
external intercostals are involved in ___________ and internal intercostals are involved in _________
external intercostals= inspiration internal intercostals= FORCED (ACTIVE) expiration
what is osteitis fibrosa cystica?
extreme acitvity in bones hypercalcemia leads to polyuria and calcuria low phosphates muscle weakness increased alkaline phosphatase
myedema is seen in what endocrine disorder. What causes it
extreme hypothyroidism increased quanities of hyaluronic acid and chondroitin sulfate bound with protein acculumation
thrombus formation usually begins with what pathway?
extrinsic
what pathway does prothrombin time look at?
extrinsic
which clotting pathway requires tissue factor to work
extrinsic
which is faster intrinsic or extrinsic pathway
extrinsic
glucose and amino acids move across the basolateral side of the tubules via _______ but on apical side ________
facilated diffusion on basolateral side GLUT transporter used for glucose secondary active transport on apical side SGLT transporter moves glucose and Na+ in Amino acids transport also moves Na+ in
which requires a plasma membrane? Facilitated diffusion or simple diffusion?
facilitated diffusion REQUIRES A PLASMA membrane
what are the functions of acid in the stomach lumen
facilitates digestion of proteins protects against some pathogens increases absorption of B12, iron and calcium
acids functions in the stomach
facilitates digestion of prots protects against pathogens increases absorption of B12, iron and calcium
insufficiency or prolapse=
failure of valves to close properly
stenosis of heart valves=
failure of valves to open completely
the secondary response is _________ than the primary response
faster, stronger, and longer than primary
which AR cells control heart rate the most
fastest pacemaker controls SA node
what makes up 1/3 daily caloric intake
fat digestion
what will not be digested on the mucosal surface of the SI, digestion is completed ENTIRELY in the lumen via pancreatic hydrolases
fats are not
what carries 25% of the bodies iron
ferritin-in the liver
what type of iron binds O2 best
ferrous 2+
where does clonal deletion occur?
fetal thymus and bone marrow (central tolerance)
cellulose=
fiber polysaccharide that cannot be digested
hydrostatic pressure from the blood inside the capillaries(Pa) favors ____
filration and keeps
Describe osmolarity in each part of the nephron
filtrate is isoosmotic in the proximal tubule hyperosmotic as it passes through the thin descending thin limb becomes hyposmotic as it passes through the TAL and early distal tubule (solute reabsorption, no water reabsorption) osmolarity of the fluid will vary as it passes through distal tubule and collecting duct (without ADH, stays hyposmotic)
the pulmonary interstitial fluid pressure is a ______ force
filtrative, typically negative duer to lymphatics
what are some hyperthyroidism symptoms
fine hair nervousness, restlessness, emotional instability, insomia exopthalmos, goiter sweating muscle wasting increased appetite weight loss fine tremor oligomenorrhea pretibial myxedema
what is the first line of defense for the glomerulotubular balance when GFR changes? What is the second line of defense
first line of defense=TGF response: autoregulation of GFR second line of defense=glomerular tubule balance(GTB)- as tubular load increase, rate of resabsorption increases, mainly occurs in proximal tubule,. depends on changes in the peritubular cpaillary and renal interstitial fluid physical forces togther these two mechanisms help prevent overloading of the distal tubule segment when GFR increases due to presure changes or other disturbances
flow in = flow out =
flow in =CO(HR x SV) flow out=Total peripheral resistance (TPR) TPR=sum of the resistance of all arterioles (vasoconstriction)
if the Re number is greater than 3000 then __________
flow is always turbulent
if the Re number is greater than 2000 then __________
flow is most likely turbulent
At a cell's resting membrane potential, the equilibrium potentials for Na+, K+, Cl- & Ca++ are such that when an ion channel for one of these ions opens, the ions will __________(usually applies)
follow their concentration gradient.
what creates the filtration slits outside of the basal lamina
foot processes of the podocytes on the visceral layer of bowmans
in terms of mutli unit smooth muscle vs single unit smooth muscle , how many varicosities are used to release NT to MULTIPLE CELLS
for single unit you only need one varosity to release to control the entire unit of cells (simple diffusion into one cell which will increase Ca2+ in all cells via gap junction but for multiunit you need multiple varicosities to control multiple cells
what is hydrostatic pressure of the interstitial fluid PIF
force exerted by fluid in the interstitial space absorptive force -3mmHg
what is colloid osmotic pressure of the interstitial fluid PiIF
force exerted by impermeable proteins in the intersitial space filtration force 8mmHg
hydrostatic pressure of the capillary (Pc)=
force exerted by the fluid pressing against a capillary wall (capillary blood pressure) Filtration force (30 mmHg on the arterial end and 10mmHg on the venous end)
low dose aspirin prevents
formation of thromboxane A2 but not prostaglandins
Beta 3 receptors act to
found in adipose tissue, heart (Gs protein and increased cAMP
Alpha intercalated cells in renal tubules are found where and do what?
found in the late distal/CCD Alpha Intercalated Cells(alpha=acidic)-(function important in acidosis)- secrete H+ and reabsorb K+ and HCO3-, primary active transport across apical membrane can secrete H+ against big gradients
what are the two types of intercalated cells and where are they found
found in the late distal/CCD Alpha Intercalated Cells-(function important in acidosis)- secrete H+ and reabsorb K+ and HCO3-, primary active transport across apical membrane can secrete H+ against big gradients Beta intercalated cells-function important in alkalosis, secrete K+ and HCO3- and reabsorb H+
Beta intercalated cells in renal tubules are found where and do what?
found in the late distal/CCD Beta intercalated cells(beta=basic)-function important in alkalosis, secrete K+ and HCO3- and reabsorb H+
what is the ejection fraction
fraction of EDV ejected/beat SV/EDV 52%
what is the [free H20]equation
free H2O=alpha1/[solute] water moves down concentration gradient towards the area with
where does the MAJORITY of acid neutralization come from in the duodenum
from Pancreatic HCO3- small amounts from bile HCO3-
what is the only monosaccharide that is imported passively through the apical membrane (ie not using Na+ secondary active transport)
fructose passive on both apical and basolateral through GLUT carriers
which monosaccharide has entirely passive transport from the lumen of the intestine to the interstitial fluid
fructose uses GLUT transporters on apical and basolateral
patients with chronically elevated MAP have baroreceptor reflexes that ________
function around a higher than normal setpoint
where does excess H+ excretion typically occur? what percentage of H+? and what systems are used
function of the late DT and CD primary active secretion of H+ in the alpha intercalated cells responsible for only 5% of H+ secretion but enough to create maximally acidified urine Pi and glutamine/NH4+ systems are used for excess H+ excretion
the orad portion of the stomach consists of _______ and produces what secretions?
fundus and body secretion of mucus, pepsinogen and HCl
what is the difference between oxyntic glands and pyloric glands
fundus glands=oxyntic gland=abdundant parietal and chief cells pyloric glands=antral glands=abudant mucus secreting cells and hormones that regulate gastric function (gastrin and somatostatin)
the basement membrane of the endothelium and the alveolar epithelium are ________
fused
what are the 4 main types of PLASMA membrane hormone receptors
g-protein couplied (Gs, Gq) Tyrosine kinase (insulin) Serine Kinase Cytokine( leptin)
what organs goes CCK act on
gallbladder-->contraction pancreas--->acinar secretion stomach---->inhibits emptying and reduces HCl secretion sphincter of Oddi--->relaxes
occludins and connexins are typically associated with what cell-cell junction cadherins are associated with what cell-cell junction
gap junctions(connexins and occludins) desmosomes=intracellular filaments and cadherins
A high solubility coefficient for a gas means that
gas diffuses more quickly into water
what factors INCREASE force of antral contractions (increase gastric emptying)
gastrin distension of stomach
what increases the force of antral contractions and thus increase gastric emptying
gastrin distension of the stomach
what activates oxyntic cells (parietal cells) to insert H+/K+ pumps into apical membrane and release intrinsic factor
gastrin (G-cells) histamine (ECL cells) acetylcholine (nerve cells, parasympathetic/enteric)
what are the two endocrine hormones of the stomach
gastrin from G-cells Ghrelin from Gr-cells
what reflexes cause the mass movements of the colon (transverse to sigmoid) pushes poop into rectum
gastrocolic and duodenocolic reflexes
what things can cause a gain of H+ in the body
generation of H+ from CO2 Production of nonvolatile acids from metabolism of proteins and other organic molecules Gain of H+ due to loss of HCO3- in diarrhea or other non gastric GI fluids Gain of H+ due to loss of HCO3- in urine
what hormone stimulates hunger
ghrelin from Gr cells in the stomach
where are meissners corpuscles found?
glabrous skin
what endocrine hormones are inactivated by thyroid hormone?
glucocorticoids (cortisol)
zona fasiculata produces
glucocorticoids (cortisol)
dextrose= permeability in RBC?
glucose always permeable in RBCs
what types of substances in the blood might have a renal threshold (plasma concentration that saturates the carrier (tubular load))
glucose amino acids phosphates sulfate urate creatinine, PAH
describe from fastest to slowest stomach emptying glucose solution protein solution solid meal
glucose solution-fastest protein solution- solid meal-slowest liquids are fastest
what do polysaccharides and dissacharides get broken down into?
glucose, fructose and galactose with the exception of cellulose which is not broken down
what enzymes do RBCs contain
glycolytic enzymes for glycolysis (no mitochondria) carbonic anhydrase
in a hypothyroid case a goiter would indicate _____ while no goiter would indicate _______
goiter=iodine definiciency=primary hyposecretion no goiter=TSH deficiency=secondary hyposecretion
what is the difference in sensation the muscle spindle vs the golgi tendon organ
golgi tendon organs are sensitive to changes in FORCE where as the muscle spindle responses to changes in STRETCH
graded potentials travel ______distances and AP travel _______ distances
graded potentials travel long distances APs travel short distances
what happens in cases of chronic hyponatremia (cell swelling)
gradual decrease in Na+ in ECF will stimulate the transport of Na+, K+ and organic solutes out of the cells This causes water diffusion out the cells brain swelling results in movement of Na+ out of the CSF to correct this you must slowly correct Na+ in theECF to avoid osmotic demyelination
Juxtaglomerular cells are also called _________primarily found in the _______ and secrete _______
granular cells primarily found in the walls of the afferent arterioles secrete renin
what are the special inhibitory cells that are used to inhibit ascending smell signals?
granule cells
what is contained in herring bodies
granules with either oxytocin or ADH bound to carrier proteins (neurophysin I and II)
what is the most common form of hyperthyroidism
graves disease
with laminar flow the velocity of flow is always _______ in the center of the vessel compared to the outside this creates a _______ profile of flow
greater in center parabolic profile of flow
Re number for LIKELY turbulent flow
greater than 2000 is most likely turbulent
Re number for ALWAYS turbulent
greater than 3000 is always turbulent
at isometric contraction the load is _______ to the maximum tension force of muscle
greater than or equal to the maximum tension force of the muscle.
what will an activated T cell do (4 things broooo)
growth and proliferation of cytotoxic and suppressor t lymphocytes growth and proliferation of B lymphocytes stimulates activation of more T helper cells activation of the macrophage system (attract and slow/stop macrophage migration away from inflamed regions) stimulate more efficient phagocytosi
what are the 4 things that activated T-helper cells CD4 do
growth and proliferation of cytotoxic(CD8) t-cells AND suppressor T lymphocytes growth and proliferation of B lymphocytes stimulates activation of more T-helper cells Activation of macrophage system (attract and slow macrophage migration away from inflamed regions, stiulates more efficient phagocytosis)
a less compliant lung will make inspiration _______ at the same pressures
harder volume change will be less at the same pressures
compared to skeletal muscle cardiac muscle has a __________duration AP and a ________ absolute refractory period which means that there is ________ tetanus and summation in cardiac muscle
has a longer duration AP than skeletal and a longer absolute refractory period thus there is no summation or tetanus in cardiac muscle
describe the micrturition reflex
has bladder fills the detrusor relaxes to keep pressure constant and then micturitiions contractions increase as pressure increase if it is powerful enough then it will override the pudenal (somatic motor) innervation to the external sphrinctor and that makes you piss yourself
what does the corticobulbar tract do?>
has fibers that originate in to the motor cortex (region for face) and terminate on nuclei in the brainstem CNV, VII, X, XII all receive input from this tract
what PaO2 level will result in an increased in alveolar ventilation
has to fall below 60mmHg
haustrations= mass movements=
haustrations=colon mixing movements mass movements=propulsive movement(transvese to sigmoid ) 1-3 movements per day
what does Hb do in presence of H+
helps buffer H+ combines with hemoglobin for buffering and HCO3- moves into plasma in exchange for Cl- (via band 3 protein)
what is the function of tubuloglomerular feedback (TGF)
helps ensure a nearly constant delivery of Na+ and Cl- to the distal nephron prevents suprious fluctuations in renal excretion
what does the glomerultubular balance help maintain?
helps to maintain the extracellular fluid volume by increasing reabsorption in response to increased filtered load
an increase in hematocrit will _______ resistance and _______ flow rate and _________ the risk of turbulent flow
hematocrit increase --->increased resistance--->decreased flow rate--->decrease in turbulent flow Q=MAP/R Re=Vxdxp/
the oxyhemoglpbin dissociation curves has what on its y and x axis (ALWAYS WATCH THIS ON EXAMS)
hemoglobin saturation % on the y pressure of oxygen in blood PaO2on the x axis
methemoglobin=
hemoglobin that DOES NOT bind O2 iron is in the ferric state can happen because of G6PDH deficiency or upon exposure to some local anesthetics (prilocaine and benzocaine).
what is methomoglobin and what will it do to the O2 binding curve
hemoglobin that does not bind O2 as well because iron is in ferric state 3+, can happen with G6PDH deficiency or upon exposure to some local anesthetic will cause a right shift
missing VIII would cause what
hemophilia
what are causes of hypotension
hemorrhage shock orthostatic hypotension other
what cells create bile
hepatocytes
what type of breathing do the following promote hering breuer reflex irritant receptors J receptors Joint and muscle proprioceptors
hering breuer=stops further inspiration and decreases rate Irritant receptors-promotes rapid , shallow breathing, coughing and sneezing J receptors- cause rapid shallow breathing and a sensation of dyspnea Joint and muscle proprioceptors- increase activitiy of DRG to increase rate of breathing
what are the respiratory reflexes that are sensitive to mechanical stimuli
hering breur reflex (stretch receptors prevent further inspiration and decrease rate) Irritant receptors(protective, cause rapid shallow breathing, coughing and sneezing) J Receptors (function unclear)- in alveolar walls, "juxtacapillary" and stimulated by alveolar inflammatory processes, cause rapid shallow breath and sensation of dyspnea Joint and muscle proprioceptors- sensitive to positon and muscle movements, increase DRG to increase rate of breathing
Veins are ______ compliance
high
what are factors that cause primary hypertension
high Na, high cholesterol obesity age gender diabetes mellitus genetics stress smoking
high compliance lung means low compliance lung means
high compliance=stretches easily-needed for inspiration low compliance=difficult to stretch
high elasticity = high compliance=
high elasticity=easy recoil high compliance=easy stretch
high frequency vibrations(700/sec) are detected by ________? and low frequency vibrations (200/sec) are detected by_____>
high freq=Pacinician Corpuscles Low freq=Meissners Corpuscles
smooth muscle relative composition of actin and myosin?
high levels of actin fewer myosin fibers than cardiac and skeletal
what are some dietary factors that increase GFR and RBF
high protein diet and high blood glucose levels these things will increase reabsorption in the PCT which ultimately reduces NaCl which is sensed by the macula densa and thus increases GFR and RBF
which thyroid hormone has a higher AFFINITY for thyroglobulin?
higher affinity=tighter bonding T4 has a higher affinity than T3
non tasters tend to have _______
higher body weighstts
less smooth muscle and less elastic tissue will give a ________ compliance vessel
higher compliance
a drop in CSF pH is reflective of ONLY what thing
higher than normal PCO2
airways with the smallest radius have the ______ individual resistance but the total resistance of that generation is the ________
highest individual resistance but lowest total resistance
what areas of the brain are most severely impacted in alzheimers?
hippocampus and temporal lobes degeneration of cholinergic neurons in the nucleus basalis of meyert that project throughout the cortex
what part of the brain intiates behavioral reactions in response to incoming sesnroy information and is involved in memory consolidation. its a part of the limbic system
hippocampus in the limbic system
what secreted factors will cause insertion of H+/K+ pumps into the apical side of oxyntic cells in the stomach
histamine ACh Gastrin
Two established gut paracrine factors
histamine (ECL cell), somatostatin (D cell).
basal secretions of acid during the interdigestive period are stimulated by _________
histamine and Ach low gastrin levels
Urticaria =
hives happens when IgE antibodies are activated from environmental pathogens in allergies
how do thyroid hormones and steroid hormones act to increase or decrease gene expression
hormones enter cell and form a hormone receptor complex in the cytoplasm or within the nucleus and this will bind to the promotor regions of genes to either activate or inactivate transcription of genes
TRPV1= TRPV3=
hot sensation (capsaicin ligand) cool sensation(menthol ligand
what is the BOHR EFFECT describing
how O2 unloads in O2 low areas (right shifts) and how it loads in O2 high areas (left shifts)
compliance=
how easily a structure stretches delta V/delta P
what is compliance?
how easily a structure stretches delta Volume/delta pressure
what substances can use simple diffusion?
hydrophobic or lipophilic substances move directly through phospholipid bilayer
what is the difference between hyperventilation, hyperpnea, and tachypnea
hyper ventilation is increased rate or volume without increased metabolism Hyperpnea- is increased rate or volume due to higher metabolism tachypnea- rapid breathing rate usually with decreased depth
what will increase surfactant production
hyperinflation of the lungs sighing and yawning exercise and beta adrenergic agonists
what are insulin levels in early type 2 diabetes what about late T2DM
hyperinsulinemia-early hypoinsulinemia-late due to loss of beta cells
what physiologic stimuli cause aldosterone secretion
hyperkalemia Hyponatermia Angiotensin II
what USUALLY causes virilization
hypersecretion of adrenal androgens
what diseases LOWER Kf and why?
hypertension and diabetes mellitus thickened basment membrane also can have decreased capillary surface area in glomerulonephritis
if a cell loses water volume and shrinks when placed into a solution then describe that solutions tonicity?
hypertonic-more impermeable solute OUTside the cell than in the cystol water flows to high impermeable solute concentration (are with less free h20)
would excessive ADH secretion cause hypoatremia or hyperatremia?
hypoarteremia, more H2O reabsorbed without Na+ being reabsorbed at equal levels so more water, decreased osmolarity
secondary hyperparathyroidism is caused by?
hypocalcemia vitamin D deficiency chronic renal disease cannot synthesize Vit D3
how would diuretics cause metabolic alkalosis
hypokalemia Or due to increase in GFR which increases secretion rate of H+ and K+ secretion
if a cell gains water and swells when put into a solution, describe that solutions tonicity?
hyposmotic (more impermeable solute inside the cytsol than in the ECF)
what is the zona fasiculata controlled by
hypothalamic-pituitary-adrenal axis CRH, ACTH
Name all hormones that are released into the median eminence
hypothalamus hormones Thyrotropin Releasing Hormone=TRH Gonadotropin releasing hormone=GnRH Corticotropin Releasing hormone=CRH GHIH=Somatostatin Growth Hormone Releasing Hormone=GHRH Prolactin inhibiting hormone (PIH) Dopamine? Prolactin Releasing Hormone(PRH)
where are the paraventicular nucleus and supraoptic nucleus located?
hypothalmus but the axons extend into the posterior pituitary
inhibition of deiodinase activity might cause symptoms of what endocrine disorder
hypothyroidism due to lack of T3 production
hypothyroidism will do what to reflex times? what about hyperthyroidism?
hypothyroidism will increase reflex times (makes them slower) hyperthyroidism causes decreased reflex times (hyperexcitablity)
which type of shock is most common
hypovolemic shock
what are the 3 types of shock
hypovolemic shock-loss of blood volume vascular shock cardiogenic shock
what are 4 factors other than a increase in ECF osmolarity, decrease in blood pressure or decrease in blood volume that would cause increased ADH secretion
hypoxia nausea nicotine and morphine Ang II
give mechanistic examples of why edema is effectively treated with the following Ice Elevation Compression
ice=vasoconstriction--->less blood in than out-->promotes drainage elevation=promotes lymphatic drainage compression=increases hydrostatic pressure of the interstitial fluid which promotes absorption
what is the most common type of hypertension 90%
idiopathic(no idea what causes it)
give a mechanistic explanation for how acidosis causes hyperkalemia (2 things)
if H+ levels in a cell go up (decreased pH) then they will bind to negatively charged proteins and displace K+ which then leaves the cells and enters the ECF AND acidosis inhibits the Na+/K+ ATPase and the Na+/K+/Cl- transporter which prevents K+ movement into the cell
Anytime a secreted H+ combines with a buffer other than HCO3- (such as NaPO4-) what happens
if an H+ combines with a buffer other than bicarbonate in the proximal, TAL, or early DT then a new HCO3- will be added to the ECF this would be a problem if the phosphate buffer system was more present in the body but most filtered Pi is reabsorbed so only a small amount of this buffer is available to interact with H+
bile acids are absorbed where in the small intestine
illeum
where is the ileocecal valve located
illeum of SI and the large intestine
where is vitamin B12 absorbed?
illeum of the SI
type III hypersensitivity
immune complex forms from IgG antibdodies and tissue damage occurs systemic lupus erythematous, gravres and MS
rheumatic fever where streptococcal M protein resembles a portion of cardiac myosin is an example of
immune tolerance failure molecular mimicry
what happens in the thick ascending limb of the loop of henle
impermeable to H2O major site of Na+, K+, Cl- reabsorption and H+ secretion By end of Loop of Henle, more solute is reabsorbed than H2O Distal end of the TAL forms part of JGA
in acidosis describe the HCO3- load vs H+ secretion in the proximal tubule, TAL and early distal tubule
in acidosis the H+ secretion>HCO3- load and excess H+ is secreted
in alkalosis describe HCO3- load vs H+ secretion in the proximal tubule, TAL, and early distal tubule
in alkalosis HCO3- load >H+ secretion and excess HCO3- will be excreted
where are the J-receptors located
in alveolar walls "juxtacapillary" stimulated by inflammatory processes (pneumonia, pulmonary vascular congestion (left heart failure) and edema
what is osmotic demyelination
in cases of chronic hypoatremia(Low Na+), brain slowly releases Na+ and K+ from the CSF to correct hypoatremia and if you add Na+ back quickly you can have loss of water from brain cells which can cause demyelination
vit D deficiency in childern is called? Vit D definiecncy in adults is called? what do both do to PTH levles
in childern=rickets in adults= osteomalacia high PTH due to low calcium absorption
in chronic hypoatremia what happens to the brain
in chronic hypoartremia as salt concentration goes down the blood becomes hypoosmotic and water will tend to migrate into cells and cause them to swell. If this happens in the brain in chronic causes the brain starts pumping solutes like Na+, K+ and organics out to raise the ECF osmolarity and stop cell swelling. Adding salt back to quickly can cause osmotic demyelination, rapid cell shrinkage and loss of myelin on neurons
describe the mechanism of the ammonia buffer system in the collecting duct in cases of excess H+ (up to 500 mEq per day)
in collecting duct cells NH3 (ammonia) enters the filtrate and combines with H+ from the primary active uniporter in the apical membrane NH3+ + H+---> NH4+ which is then excreted as acid H+ is not combining with HCO3- in the filtrate and thus new HCO3- is being added to the ECF
what is the purpose of band three protein
in pulmonary capillaries it works to transport Cl- into plasma and transport HCO3- in this helps with CO2 expiration via carbonic anyhdrase
where can the filtrates osmolarity be variable depending on ADH presence or absence
in the Late Dt and cortical collecting duct and in the medullary collecting duct
describe lumen charge difference in early PT vs the late PT and describe what causes this
in the early PT there is a -4mV charge in the lumen due to large amounts of Na+ reabsorption and only paracellular transport of Cl- in late proximal tubule there is a +4mV charge due to H+ secretion and secondary active Formate/Cl-antiporter and basolateral facilitated diffusion, this brings Cl- out of the lumen and into the cells
where do thiazide diuretics work
in the early distal tubule by blocking the Na+-Cl- cotransport mechaism in the early distal tubule
where does PTH stimulate the formation of Vit D3
in the kidneys
where does carbohydrate digestion begin
in the mouth when food is exposed to salivary amylase
most substances are completely digested and absorbed in the _______ part of the ______ what would be a potentional exception
in the proximal part of the small intestine dietary fat is the potential exception
where are the motor axons of corticospinal tract located
in the pyramids of the medulla oblongata crossing over occurs here
both SA and AV nodes are located
in the right artria
where are triglycerides resynthesized from their MG and FA breakdown products in intestinal cells
in the smooth ER also coated to form chylomicrons before exocytosis into lacteals
where does fat digestion begin?
in the stomach via lingual lipase but its <10% and insignificant
where are the water soluble vitamins absorbed and how?
in the upper small intestine cotransported with Na+
where are the macula densa cells located
in the wall of the TAL in close contact with the JG cells
what type of immune mediator in type I hypersensitivity? what type of mediator in type IV
in type I its IgE in type IV its cell mediated
shock=
inadequate blood flow to meet tissue needs 3 types
what is the I-band(light) composed of
includes only thin filaments
what will endothelin do to renal arterioles and what happens to RBF and GFR
increaed afferent and efferent resistance and decreased RBF and GFR
increased proteins (amino acids) or high blood glucose levels will do what to GFR and RBF
increaed amino acids from HIGH prot diet will increases proximal tubule amino acid reabsoprtion which also increases NaCl reabsorption which decreaess macula densa NaCl which leads to decreased afferent arteriole resistance and increased GFR THESE LEAD TO PRONOUNCED INCREASES IN RBF AND GFR
increased distal tubule flow rate will ________ K+ secretion
increase K+ secretion keeps luminal K+ lower which allows for a sufficient concentration gradient to drive secretion also increases BK channels in the apical membrane
shifting blood from veins to arties will do what to MAP
increase MAP
increasing alveolar ventilation will _________ PAO2, normal value is _________ PaO2 normal value is=
increase PAO2 PAO2=100mmHg PaO2=95 mmHg
aminocaproic and transexamic acid will do what to clotting?
increase duration of clotting by decreasing plasmin formation
Beta 1 receptors act to
increase heart rate and contractility, increase lipolysis, increase renin secretion, increase protein content in salvia (Gs protein, increased cAMP)
an increase in MAP will cause an _______ in AP firing fate to the brainstem and cause ______
increase in AP firing increased parasympathetics to the heart decreased sympathetics to heart arterioles and veins
elastic recoild of the chest wall favors an __________
increase in lung volume or expansion
lowering artery elasticity will cause the heart to _____
increase in size because it has to work harder to overcome an increased afterload
what is reactive hyperemia
increase in tissue blood flow following a period of low perfusion if blood flow to a tissue is occlused then paracrines accumulate in the interstitial space
increasing alveolar ventilation will _____ PAO2
increase it
increasing arteriolar diamter will do what to net filtration
increase it by increasing flow into the capillary and increasing Pf
how do osmotic diuretics works
increase nonabsorbable substances which are filtered and increase the osmolarity of the filtrate this means that water must be used to help excrete them
+ionotropic agents will ________ activity of phospholamban
increase phospholamban which increases Ca2+ ATPase activity on SR increases Ca2+ release and Ca2+ return increases Force of contraction and increases rate of contraction
nitrous oxide will _______ respiratory reate and ________ tidal volume so there is a _______ change in ventilation and PaCO2
increase respiratory rate and decrease tidal volume minimal change in minute ventilation and PaCO2
what do long neural reflexes do when they are stimulated by increased acidity, increased fat, increased amino acids, hypertonicity and distension in the dueodenum
increase sympathetic efferents and decrease parasymphatic efferents this slows gastric emptying by decreasing force of antral contractions
increasing the crossbridges will _________ the force
increase the force
adding a hypotonic NaCl solution to a person would do?
increase to both ECF and ICF volume decrease in both ECF and ICF osmolarity
endothelial 1 will
increase tone and contract smooth muscle
what causes aldosterone "escape"
increased ANP(directly inhibits Na+ and H2O reabsorption, increases GFR and inhibtis renin/aldosterone release) and pressure natriuresis(increased Na+ excretion in response to increased MAP) means that increased aldosterone will only increase reabsorption to a certain extent, over time aldosterones effects disappate
how does presynaptic facilitation occur
increased AP so there is increased Ca2+_
hypercarbia=
increased CO2 levels in blood
describe H+, HCO3- and CO2 concentrations in metabolic acidosis
increased H+, decreased HCO3-(primary abnormality), decreased CO2(from respiratory reflex of increased ventilation)
what will increased ECF osmolarity do to K+ concentration?
increased K+ concentration in ECF moves K+ out of cells
increases to total blood volume (increased NaCl intake) will lead to _______ MAP
increased MAP
what is the myogenic autoregulation mechanism
increased MAP increased arteriolar blood flow increased stretch which opens mechanically gated Na+ channel in VSM depolarizes membrane which opens v-gated Ca++ Ca++ entry and binds to calmodulin activates myosin light chain kinase increased myosin ATPase activity VSM contraction and vasoconstriction
give myogenic autoregulation mech
increased MAP, increases arteriolar blood flow, increases arteriolar stretch. Opens a mechanically gated Na+ in VSM which depolarizes membrane and opens v-gated Ca++ channels in VS---> Ca++ binds calmodulin which actives MLCK which increases myosin ATPases activity and VSM contraction and vasocontrics which reduces flow to the tissue
aortic and carotid bodies both increase rate of firing in response to ________ but only the carotid bodies have an increase in firing with ________ that is independent of CO2 control mechanisms
increased PCO2 and low O2 will cause aortic AND carotid bodies to fire to increase ventilation, not as powerful as central respone but 5x quicker ONLY carotid bodies have a response to arterial pH this is independent of CO2 control mechanism this means that it can further increase response when combined with high PaCO2
what are the stimuli for increased H+ secretion and HCO3- reabsorption (6 things...)
increased Pco2 increased H+, decreased HCO3- (note:^all those describe acidosis and most important stimuli) decreased ECF volume increased ANGII increased Aldosterone hypokalemia
zofran does what to QRS
increased QRS interval
what causes a goiter?
increased TSH secretion due to lack of negative feedback OR from a anterior pit tumor High TSH stimulates thyroid to secrete large amounts of thyroglobulin colloid into follicles which enlarges the gland
what things will increase principal cell K+ secrtetion
increased [K+] ECF increased aldosterone increased distal tubule flow rate acid/base status---alkalosis will cause increased K+ secretion
what factors result in K+ secretion by principal cells
increased [K+] in the ECF increased aldosterone increased distal tubule flow rate Alkalosis.... <----MAKE SURE YOU KNOW THIS, its different from what you would think
What will NE and epi do to renal arterioles? and what happens to RBF and GFR
increased afferent AND efferent resistance which decreases RBF and GFR
what would conns syndrome do to bodys acid base balance?
increased aldosterone (increased K+) metabolic alkalosis
what is SIADH (syndrome of inapropriate ADH). what can cause it?
increased and uncontrolled secretion of ADH that causes volume expansion and hyponatremia surgery, pain stress, temp change, tumor, TB
increased _______ and/or increased _____ will result in more O2 delivery to tissues
increased blood flow and/or increased metabolism
thirst is increased by what 4 things
increased by ECF hyperosmolarity decreased ECF volume decreased MAP Angiotensin II
why would burns or inflammation cause edema?
increased capillary permeability more flow in than out baby
what are the metabolic effects of thyroid hormones?
increased carb metabolism (increased glycolysis and gluconeogenesis, increased glucose uptake, increaed CHO absorption from GI) stimulates protein synthesis and protein catabolism stimulates fat metabolism
how does presynaptic inhibition occur
increased cl- conductance (reduces AP size) which decreases the Ca2+ entry and the amount of NT released
hyperkalemia (<6mM) does what to Vm
increased excitability depolarizes Vm moving it closer to threshold
why does alkalosis cause hypokalemia
increased intracellular pH causes K+ uptake by cell
increasing load on muscle will do what to contraction speed?
increased load results in SLOWER contraction speed
describe all of secretins actions
increased pancreatic and bilary HCO3- secretion increased PEPSIN decreased acid secretion decreased gastric emptying
what are all of CCKs actions
increased pancreatic secretion increased gall bladder contraction relaxation of sphincter of oddi gastric receptive relaxation decreased gastric emptying decreased gastric acid secretion
anti-cholinesterases can cause?
increased parasympathetics Sialorrhea (drooling) no breakdown of Ach at synaptic cleft used to treat alzheimers
what things will increae aldosterone secretion
increased plasma K+ increased angiotensin II changes associated with Na+ and low volume//low BP
factors that increase ADH secretion
increased plasma osmolarity decreased blood pressure pressure (direcelty via baroreceptors) decreased blood volume (via decreased ANP) Nausea Hypoxia Nicotiner and Morphine AngII
what happens to B-adrengergic receptors with thyroid hormone presence
increased presence of B-adrenergic receptors (control heart rate for sympathetics) permissive action for catecholamines
what happens to large vessels that do not constrict in response to increased MAP in chronic hypertension
increased size of VSM cells (hypertrophic remodeling) increases total cross sectional area of vessels large vessels become stiffer(less compliant)
what will Angiotensin II release do to ADH secretion
increases ADH secretion
what will Nicotine and morphine do to ADH secretion
increases ADH secretion
what will hypoxia do to ADH secretion?
increases ADH secretion
what will nausea do to ADH secretion
increases ADH secretion
what does angiotensin II do
increases BP via vasoconstriction and aldosterone secretion (Na+ and H20 retention) to increase Blood volume ALSO it increases resistance of the EFFERENT ARTERIOLE
the glomerular capillary colloid osmotic pressure will ________ along the length of the glomerular capillary
increases along the length of the capillary affected by filtration fraction
GH and IGF-1 will have what effect on bone and cartilage growth
increases bone turnover by increasing activation of both osteoclasts and osteoblasts Also stimulate chondrogeneiss and widening of the epiphyseal plates
PTH will _____ calcium levels and ______ phosphate levels
increases calcium levels decreases phosphate levels
Obstructive lung diseases (like emphysema) will _________ compliance which means ________
increases compliance, less elastic fibers means that they will breathe deep and slowly to reduce the work of breathing
what are the problems with turbulent blood flow
increases friction and the energy required to drive flow increase the risk of endothelial injury and plaque development increases the possibility of thrombotic events
what are all the risks associated with turbulent blood vessel flow
increases friction and the energy required to drive flow increases the risk of endothelial injury and plaque development increases possibility of thrombotic events
conduction velocity of APs can increase with what two things?
increases if axons have myelin increases with increasing axonal diameter
what does angiotensin II do to H+ secretion?
increases it
hypocalcemia does what to Vm
increases membrane excitability
what does N2O do in the respiratory system
increases respiratory rate and decreases tiday volume so there is minimal change in minute ventilation and PaCO2 levels BUT Hypoxic drive is decreased by N2O N2O INCREASES pulmonary vascular resistance (decreases perfusion) Nitrous oxide is a mild sympathominetic
in type I hypersensitivty, degranulation of mast cells causes ________ respiratory resistance and ______ blood pressure
increases respiratory resistance decreases BP that bad brah
contents such as increased acidity, fat, amino acids, hypertoncitity and distention of the duodenum does what ANS systems in the long neural reflexes
increases sympathetics efferents and decreases parasympathetic efferents to decrease stomach emptying those stimuli also cause release of CCK, Secretin and GIP and short neural reflexes via enteric neurons to reduce gastric emptying
muscle hypertrophy will do what to QRS complexes?
increases the voltage and duration of QRS complexes
Ang II release does what to the thirst mechanism?
increases thirst
what will increase pressure damping
increasing compliance or increasing resistance
what can increase the ability for temperature detection?
increasing the area of receptors exposed you increase the receptive fields and the percieved sensation
what are the TWO ways you can increase the total force of a contraction
increasing the frequency of fiber activation and/or increasing the number of muscle fibers contracting
increasing what factors (3 things) will increase Re and thus increase turbulent flow
increasing velocity diameter of blood vessels density of blood
hyperkinetic disorders are caused by damage to what pathway of the basal nuclei? huntingtons disease
indirect pathway damage indirect is inhibitory
NO and Prostacyclin(PGI2)
inhibit aggregation and activation
loop diuretics will do what and act where
inhibit the Na+/K+/2Cl- cotransport pump on the luminal membrane of the TAL of Henle
Anticholinergic like amitriptyline (Elavil) drugs do what?
inhibit the effects of acetylcholine systemically via muscarinic receptors can cause GI problems and xerostomia,
patient presents with high T4 and T3 levels but shows clinical signs of hypothyroidism... what could be happening?
inhibition of deiodinase activity (ex, selenium deficiency, burns, fasting, stress) deiodinase is needed at the target tissues to convert T4 to the more potent T3
increased HCl in gastric lumen inhibits ________ and stimulates _________
inhibits G-cells (gastrin) stimulates D-dells (somatostatin--->inhibits parietal cells)
glycyrrhentinic acid, a compound of licorice does what
inhibits activity of 11B-hydroxysteroid dehydrogenase
what does asprin do to clotting at high doses
inhibits formation of prostacyclin at low does it only inhibits formation of thromboxane A2
what does calponin do
inhibits myosin ATPase
what does caldesmon do
inhibits myosin actin bond
interferons are part of what immune system
innate nonspecific second line of defense
what specific regions of the brain REGULATE the CPG frequency (sent from brainstem) and what pathway is utilized?
input from the higher cortical regions (nuclei in pons and medulla) can regulate the CPG frequency VIA the corticobulbar pathway this pathway involves the gigantocellularis and the parvocellular reticular
when does vitamin B12 bind TCII
inside the cells of the illeum after intrinsic factor is broken down B12 binds TCII and the complex is exocytosed into the blood
factors that decrease the concentration of K+ in ECF (shifts K+ into the cells)
insulin aldosterone B2-Adrenergic Stimulation Alkalosis Decrease in ECF Osm
factors that increase K+ concentration in the ECF(shifts K+ out of the cells)
insulin deficiency aldosterone B2 adrenergic antagonists acidosis increased ECF Osm Strenuous Exercise Cell Lysis
what are the factors that increase ECF K+ (shift K+ out of the cells)
insulin deficiency aldosterone deficiency (addisons) B-2 adrenergic antagonists acidosis Increased ECF osmolarity strenuos exercise cell lysis
What hormones in addition to calcitonin lead to bone formation
insulin, GH, IGF-1, estrogen and testosterone
what are the expiratory muscles (only used for forced expiration)
internal intercostals and abdominal muscles
what are ALL of the muscles of expiration
internal internal intercostals expiratory muscles only contract with ACTIVE expiration abdominal muscles push abdominal contents against the diaprapm external oblique internal oliquie transverus abdominis rectus abdominis
what is an INR
international normalized ratio
where are hypothalamic hormones released (be specific)
into the primary capillary plexus in the median eminence
what pathway does activated partial thromboplastin time look at?
intrinsic
what is molecular mimicry
invading pathogens have antigens that are similar to self antigens this is what happens in rheumatic fever strepto M protein resembeles a portion of cardiac myosin
what are the transverse T-tubules
invaginations of sarcolemma
With a UNILATERAL lesion of the spinal cord, one would expect to lose _____ lateral touch/pressure & _____ lateral pain/temperature sensations below the injury level.
ipsilateral contralateral
what gets recycled when RBCs die
iron
what type of contraction occurs when force is produced that is LESS than the load with NO MOVEMENT
isometric
what type of contractions do golgi tendons stretch in response to
isometric maximal contractions
what is the difference between isometric contraction and isotonic contraction
isometric- force produced is less than the load (NO MOVEMENT) isotonic- force produced is great enough to move a load
when does renal filtrate first become hypoosmotic when traveling through the nephron
isoosmotic as it passes through the PCT and then becomes hyperosmotic when it passes through the thin descending limb and then hyposmotic as it passes through the Thick ascending limb and early distal tubule
describe osmolarity in the proximal tubule
isoosmotic in proximal tubule Na+ reabsorbed pulls water with it
Under normal circumstances, ECF Osm. is _______ to Cell cytosol what is normal ECF osmolarity of impermeable solutes? what about normal cystol?
isotonic no net change in volume 300mOsm of non permeable solutes in both cytosol and ECF
what type of contraction is when FORCE IS GREAT ENOUGH TO MOVE A LOAD
isotonic contraction
where does peristalsis begin in the small intestine
it can begin ANYWHERE its normally weak and dies out after traveling short distances
where does peristalsis begin in the small intestine?
it can begin anywhere in the small intestine
the liver can secrete more bile salts than ______
it can secrete more bile than it synthesizes because it reaborbs it through enterohepatic circulation
what is the purpose of the 11B-hydroxysteroid dehydrogenase
it converts cortisol into cortisone cortisol can bind mineralcorticoid receptors (aldosterone receptors) which can cause hyperaldosterone symptoms however cortisone does not bind to the MR receptors as well
what happens to bile concentration in the gall bladder
it increases
what happens to the glomerular capillary colloid osmotic pressure as you move through the glomerulus, what does this mean for GFR as you move down the length of the glomerular capillary
it increases glomerular colloid osmotic pressure (loss of filtrate but not loss of proteins), this opposes the hydrostatic pressure which decreases GFR and net filtration
high dose aspirin is not a good anticoagulant because
it inhibits Thromboxane A2 (stimulates aggregation and activation) AND prostacylin (inhibits aggregation and activation) lol this eliiminates both the stimulation for clot development and the inhibtor. doesnt do much for prevent coagulatuation
what does the velocity of contraction depend on?
it is dependent on the load of a fiber it is contracting with ASWELL AS the type of fiber Type I will be slow and Type IIB will be fast
what will ateriosclerosis do to pulse pressure?
it reduces compliance thus increases pulse pressure SV/C=PP
without carbonic anhydrase what would happen to PaCO2
it would equal 80 mmHg compared to the normal 45 mmHg would be wayyy higher because it would not get converted to HCO3- and it would not be transported out of the blood as quickly
what would glomerulonephritis do to GFR and why?
it would lower GFR by decreases Kf(permeabiltiy) through decreased capillary surface area
why doesnt pepsin work in the small intestine?
its inactivated by basic pH in small intestine there are plently of other enzymes to work on prot digestion there
jaw closing muscles have _________ muscle spindles and jaw opening muscles have _________ muscle spindles
jaw closers have A LOT of muscle spindles Jaw openers have few to no muscle spindles
jaw opening reflex is caused by? what occurs? Jaw jerk reflex is caused by? what occurs
jaw opening=pain causes inhibition of alpha motor neurons to open the jaw jaw jerk=strong tap on chin stretches the jaw muscles and they respond with contraction, STRETCH reflex
I bands include what parts of the sacromere
just thin filaments and the z-lines
what is the JGA composed of
juxtaglomerular cells in the afferent arterioles, secrete renin Macula densa cells in the wall of the thick ascending limb- in closa contact with the JG cells , they sense Na+ and Cl- in filtrate
what is the main function of tubuloglomerular feeback and what are its targets
keeps GFR constant by making changes in Afferent and efferent arteriole resistance via sensing NaCl inb macula densa
why would diabetes cause hyperkalemia? (3 reasons)
kidney disease acidosis-shifts K+ out of cells decreased insulin or insulin resistance means that there is less Na+/K+ ATPase activity, less K+ going into cells
what would Addisons Disease do to the bodys acid base balance?
lack of aldosterone means that there is less Na+ reabsorbtion and K+ secretion this would cause metabolic acidosis
in terms of clotting what would hypocalcemia causes
lack of clotting because Ca++ is needed in the clotting cascade pathway
what is thrombocytopenia
lack of platelets, causes spontaneous bleeding in small blood vessels anything that affects bone marrow can cause this normal movement can cause internal hemorrphaging (petechiae) in skin
what is cretinism? what are the two types?
lack of thyroid hormones during development causes lack of postnatal brain maturation physical and mental retardation and inhibition of skeletal growth Cogentital cretinism=cogentital absence of the thyroid gland Endemic cretinism=iodine deficient diet
what is inside the villus?
lacteals and capillary network
low compliance vessels will have _________ with ___________
large changes in pressure with small change in volume (arteries)
in pulmonary edema these is an increae in what type of starling force? what type of heart failure can cause this?
large increaes in net capillary filtration left sided heart failure not removing blood from pulmonary fast enough build up of pressure
teniae coli=
large rings of longitudinal muscle in the colon
where are other baroreceptors located
large systemic veins, pulmonary vessels, and the walls of the heart contain barorecepots
what type of vessel will undergo an increase in total cross sectional area with chronic increased MAP
large vessels have an increase in total cross sectional area! SMALL DO NOT have an increase
what is the difference in long term response to increased MAP (hypertension) in large vessels vs small vessels
large vessels-hypertrophic remodeling=increased total cross sectional area and less compliant (stiffer) small vessels-inward euthrophic remodeling-VSM growth around a narrowed lumen (increaese resistance) and there is NO CHANGE in cross sectional area of vessel
what type of urine in diabetes insipidus?
large volume hypotonic and tasteless(insipid)
graded potentials often ________ than APs
last longer
aldosterone acts on the ______ portion of the nephron and does ______
late DT and CD increased NaCl, H2O reabsorption increased K+ secretion
what three regions of the nephron have sites of action for aldosterone and ADH
late distal and Cortical collecting ducts (principal cells) and Medullary collecting duct
hypoparathyroidism will lead to ________ levels of Ca+ and _______ Na+ permeability which leads to?
leads to hypocalcemia which increases Na+ permeabiltiy and leads to neuromuscular excitibility an muscle spasms as well as TETANY
what is the dominant hemisphere in 95% of people
left hemisphere
which mean electrical shift happens at the end of deep expiration? what about the end of deep insirpation
left shift heart <59 degree=end of deep expiration right shift heart >59 degrees=at the end of inspiration
what will cause a left shit to the oxyhemoglobin dissociation curve
left shift=more loading and less unloading of O2 decreased PCO2 increased pH (7.6) Decreased 2,3 BPG
CO causes a _________ shift to the O2 dissociation curve
left sift
CO bound to hemoglobin will cause a ______ shift to the hemoglobin curve
left ward shift increases Hbs affinity for O2
give a mechanistic explanation for how alkalosis causes hypokalemia
less H+ bound to proteins inside cell so there is more K+ permitted into the cell this moves K+ out of ECF and into cells
temperature regulation is ______ precise in young childern
less precise and usually higher temp
what is most responsible for thyroid hormone negative feedback
levels of T4 acting on the anterior pituitary to inhibit TSH secretion
what are the 5 factors influencing taste perception
ligand concentration(lower gives higher specificity) Other sensory input (like smell) taste aversion taste adaption taste preference
what kind of receptors are the nicotinic receptors?
ligand gated ion channels (ionotropic) selective for both Na+ and K+
what are the emotive aspects of olfaction derived from?
limbic projects amygdala and hypothalamus
high compliance vessels can have large changes in volume with __________
little change in pressure, VEINS
why might a new born need vitamin K shots
liver not fully functioning need vitamin K for clotting factors
merkels disks function to do what? where are they found and what type of adaption?
localize continuous pressure and sensing an objects texture found in all skin tonic adaption (slow)
superficial somatic pain is ___________ while deep somatic pain is?
localized and sharp, prickling or burning deepsomatic-dull, aching and diffuse CAN BE REFERRED
where are beta 1 receptors located and what is the major function
located in cardiac muscle, and the JGA increased HR, increased contractions of the heart, increased renin release increased cAMP
where is the nucleus tractus solitarii located and what does it do
located in medulla with purely sensory function receives input for taste, chemoreceptors and aortic bodies
where are the vestibular nuclei located and what do they do?
located in pons and medulla oblongata transmit excitatory signals through the lateral and medial vestibulospinal tract to control antigravity muscles FUNCTIONS WITH THE PONTINE reticular nuceli
where are pacinian corpsucles located and what kind of adaption do they exhibit?
located in subcutaneois tissue, viscera and joints Rapid Adaption/phasic
in a first degree heart block there is a long _________ interval
long PR interval
which diuretics act of the Na+/2Cl-/K+ transporter in the TAL
loop direurtics: furosemide ethacrynic acid bumetanide
what is the most powerful diuretic available
loop diuretics (Furosemide, ethacrynic acid, bumetanide act on the Na+/K+/2Cl- transporter may allow 30% of the GFR to appear in uriner overwhelms downstream capacity
where does CO2 bond hemoglobin? is this fast or slow?
loose reversible bond with Hb on TERMINAL AMINE GROUPS SLOWEST OF THE REACTIONS
agnosia=? Ageusia=? Anosmia=
loss of association (could be taste or smell) Ageusia=loss of taste perception Anosmia=loss of smell perception
what type of neurons are lost in parkinsons disease(hypokinetic)
loss of dopaminergic neurons from the substantia nigra (midbrain) which normally project to the striatum (basal nuclei) where they inhibit Cholinergic neurons
why would pulse pressure increase with ateriosclerosis
loss of elasticity means that there is a larger difference in diastolic vs systolic pressure
edema is caused by
loss of lymph drainage (no ability to drain the net filtration) loss of normal balance between Pc and colloid osmotic pressure of capillary/interstitial fluid
what happens in minimal change nephropathy
loss of negative charge on GBM proteins are allowed through proetinuria occurs (protein in urine)
what are the causes of edema
loss of normal lymph drainage loss of normal balance between Pc and piC (ie increased hydrostatic capillary pressure, decreased colloid osmotic capillary pressure, or increased colloid osmotic interstitial pressure
what are the most common causes of vascular shock
loss of vasomotor tone associated with anaphylaxis (allergic reaction, anaphylatic shock) loss of nervous system regulation (neurogenic shock) septicemia(septic shock, a bacterial infection)
why might many diuretics cause K+ loss (hypokalemia)?
lots of them increase the flow rate of filtrate through the distal nephron which decreases K+ reabsorption increases secretion
arteries are ______ compliance
low
low levels of free calcium lead to neuronal _________ while high levels lead to neuronal _________
low levels=neuronal excitability high levels=neuronal depression
what happens to renin levels in Conns syndrome what happens to body pH
low plasma renin hypokalemia causes alkalosis
the higher the resistance the ______ the flow
lower
what parts of the gut musclature are involvunatery
lower 2/3 of esophagus, stomach, small intestine, large intestine, gallbladder, biliary and pancreatic ducts
the lower the PO2 the _______ O2 will dissociate from hemoglobin
lower PO2 means O2 is MORE likely to dissociate HG
2,3 BPG will __________ affinity to O2 and cause ___________
lower affinity to O2 more O2 unloading right curve shift
lungs with lower compliance (pulmonary fibrosis) require a __________ transpulmonary pressure to _________
lower compliance lungs require a larger transpulmonary pressure Ptp to increase volume
if ventilation is limited then V/Q is _______ and thus O2 is ______ and CO2 ______ so smooth muscles ________
lower ventilation means that V/Q is lower and O2 is low and CO2 is high thus there is vasocondstriction
what will increasing afterload on the heart do to a single action potential time. What does this do to stroke volume
lowered AP due to lowered ability of muscles to shorten this will decrease the stroke volume
what are PTHs actions in the kidneys
lowers phophate resorption, increases excretion increases calcium reabsorption, decreases excretion increases Vit d3 production
there is typically more filtration than absorption in the capillaries. so what returns filtered fluid to the CV system
lymphatic system
macrophages can phagocytize _________ than neutrophils and macrophages ______
macrophages can phagocytize far more and larger material than neutrophils macrophages are already in tissue
what are the APCs
macrophages, lymphocytes, and dendritic cells (ingest antigen and migrate to nearest lymphoid organ)
Where is IGF 1 produced?
mainly in the liver but it is produced in most tissues and acts on neighboring cells in a paracrine manner
reflex control=
maintains MAP so there is adequate blood flow to the brain and heart reflex control can override local control function of the NS and ES
antigen presenting cells present antigens via the ___________
major histocompatibiltiy complex (MHC) class II APCs bind to and activate T helper cells
fast twitch glycolytic fibers make up which motor units and when are they recruited?
make up LARGE motor units these are recruited LAST
which sex has a higher hematocrit
males-40-54% 37-47% in females
which would be precieved first, a mechanical or thermal sensation
mechanical because it uses Abeta fibers and thermal uses C fibers and Adelta
what are gogli tendon organs
mechanosensitive receptors that are found at the junction of tendons and muscle, SENSITIVE to a change in FORCE IT IS A PROTECTIVE REFLEX
respiration is primary controlled by what two areas in brainstem
medulalry respiratory centors (Dorsal Respiratory Group, Ventral) Pountine respiratory group (penumotaxic center, apneustic center)
what part of the nephron has increased permeablity to urea when ADH is present
medullary collecting duct
what are platelets derived from
megakaryocytes
lower frequency vibration (200 cycles/sec) is detected by which receptor?
meissners corpuscles and uses dorsal column pathway
how is trypsinogen activated
membrane bound enterokinase in the intestinal lumen activates into trypsin
which blood volume is bigger men or women
men- 5L women-4L
what is the most direct route between arteriole and venule?
metaarteriole/thoroughfare channel
what can cause an ehanced response to PaCO2 (increased breathing)
metabolic acidosis
describe specific numbers for pH, HCO3-, and PCo2 for respiratory metabolic acidosis
metabolic acidosis would mean that you have a pH less than 7.4 with a HCO3- concentration of <24 mEq/L with a PCO2 level of less than <40 mmHg more HCO3- and less CO2 from respiratory compensation
bilirubin/biliverdin are produce by
metabolization of Hb in the liver
what receptor does umami taste use
metabotropic glutamate receptors
Warm and Cool receptors are best able to detect a change at the___________of their temperature sensitivity (that is where they are most sensitive). What happens if nociceptors get activated too?
mid range if nociceptors are activated they get even better
zona glomerulosa produces
mineralcorticoids (aldosterone)
what initiates ureter peristalsis
minor-->major calyces being stretched by urine autonomics can enhance (parasympathetics) or decrease (sympathetics)
what do olfactory receptor cells synapse with?
mitral cells in the olfactory bulb
what do olfactory cells synapse with after passing through the ethmoid bone?
mitral cells in the olfactory bulb Glomeruli are where the short acons from olfactory receptor cells terminate and synapse with the mitral cells
what is CaO2
ml of O2 barried by oxyhemoglobin plus ml of O2 carried dissolved in plasma
what does PTH do
mobilizes Ca+ from bone enhances renal absorption of calcium increases intestinal absorption of Ca+ indirectly through D3
what is the function of mesangial cells
modified smooth muscle cells that surround the glomerular capillary loops NOT a part of the filtration barrier modify the size of the filtration slits and alter rate of fltrate production
what are the determinates of solute permability to to the glomerular membrane?
molecular size(>50A wont go through) ionic charge (cations filter better than anions) proteins are both large and negatively charged and dont filter well
what is the stimulus for the unami taste receptor
monosodium glutamate, enhanced by ribonucleotides
what happens to the face in cushings disease and syndrome?
moon facies with erythema and telangiectases of cheeks and forehead
intrapleural pressure is _____ in zone 1
more negative
what TEPD favors K+ secretion in the distal tubule
more negative TEPD due to increased Na+ reabsorption with high [K+] in ECF favors K+ secretion
base of the lung recieves more ________ than ________ thus its V/Q is lower
more perfusion than ventilation
the more sensitive a receptor the _________ the amplitude from set point. The less sensitive a receptor the _________ the amplitude
more sensitive=lower amplitude from set point less sensitive=larger amplitude ffrom set point
more solute mean _______ [Free h2O] less solute means _______ [free h20] water moves via osmosis towards area with _________
more solute=less free h20 less solute=more free h20 h20 flows to the area with less free h20 down its concentration gradient
IgM properties (3 things)
most potent activator of the complement LARGEST of the immunoglobins produced at first response to antigen
the small intestine has very high reserve capacity because? what does this really mean?
most substances are completely digested and absorbed in the proximal 25% of the small intestine (fat is a potential exception) large intake produces large absorption (increased storage and obseity
what parts of the GI tract have voluntary striated muscle
mouth, oropharynx, upper esophageal sphincter, upper 1/3 of esophagus, external anal sphincter
what parts of the gut musculature are voluntary striated muscle
mouth, oropharynx, upper esophageal sphincter, upper 1/3 of esophagus, external anal sphincter
absorption describes what bulk flow movement
movement from the interstitial fluid to the plasma
filtration describes what bulk flow
movement of fluid from plasma to the interstitial fluid
how is autotransfusion do?
movement of intersitial fluid into capillaries is from decreased arteriolar constriction which decreases Pc
what 3 things happen in autotransfusion
movement of interstitial fluid into capillaries arteriolar constrction leading to decreased Pc net absorption of fluid into capillaries
what is bulk flow
movement of protein free fluid between plasma and interstitial fluid occurs through water filled channels distributes ECF volume Either filtration or absorption movement occurs magnitude and direction of fluid movement is determined by the pressure gradient
compared to system tissues the interstitial colloid osmotic pressure pi(if) is
much larger helps maintain filtration
what GI layer contains the muscularis mucosa?
mucosa muscularis mosa moves the villi also contains lamina propria and simple columnar epithelium
the four GI layers are
mucosa submucosa muscularis externa serosa
what layer of the GI tract contains the lamina propria? what other things does this layer have
mucosa layer has simple columnar epithelium lamina propria muscularis mucosa (for movement of villi)
interneurons are typically what structural classifications
multipolar and anaxonic
motor neurons are typically what structural classification
multipolar nerons
high levels of creatine kinase might mean what?
muscle cell damage
how do muscle spindles protect against chewing hard objects that break down quickly(think chewing on a nut that then cracks)
muscle spindles decrease the contraction when the nut cracks the force is now much greater than the load so now there is slack in the muscle spindle and there is less activation of the alpha and gamma motor neurons leading to decreased force
what are the 4 layers of the GI tract wall
muscosa, submucosa, muscularis externa (circular muscle/longitudinal muscle/myenteric plexus), serosa
what must happen to transmural or transpulmonary to produce expiration
must decrease Ptp for expiration
what must happen to transmural or transpulmonary pressure to produce inspiration
must increase Ptp for inspiration
what causes achondroplasia?
mutation in the FGF-3 receptor that causes it to be overly active and inhibits cartilage growth at the growth plates so limb growth is reduced (growth of the trunk of the body is not impacted)
mutations cause a change to which structure of a protein? what about pH, Temp, Osmolarity? covalent/allosteric modulation?
mutations=primary structure alterations pH, Temp, osm=LOSS of the 2nd, 3rd, 4th structures=denaturation covalent/allosteric modulation- CHANGE in 2nd, 3rd, 4th
which plexus controls the muscles of the muscularis externa via increase tone of gut wall increase intensity of rythmic contractions slight increase in the rate of rhythmic contractions increase conduction velocity of the electrical waves along the gut wall inhibition of sphincter contraction
myenteric plexus-linear chain of neurons that extend THE ENTIRE length of the GI tract
what is the rigor state
myosin and actin are tightly bound
what happens in the latch state
myosin is dephosphorylated while it is still bound to actin causing tension to be maintained although Ca++ levels in the cytosol decrease and ATP usage decreases
to relax contracted smooth muscle what must occur in myosin
myosin must be dephosphorphylated by myosin light chain phosphatase
thick filament= thin filament=
myosin=thick actin=thin
do smooth muscle cells use troponin?
nah bro they use calmodulin for calcium binding
what are the two mechanisms of capillary exhange that use bulk flow? which one does not?
narrow water filled spaces-intercellular space (no tight junctions) and vesicles fusing to form water filled channels are both bulk flow mechansims Transcytosis and transepithelial transport use simple diffusion
what is myogenic autoregulation
nearly all organs tend to keep their blood flow constart despite variations in arterial pressure (F=MAP/Rtissue), it is a reflex arteriolar constriction in response to increased MAP
under normal conditions acid secretion in the renal tubules needs to be enough to accomplish what?
needs to be enough to reabsorb almost all filtered HCO3- and rid the body of non-volatile acids produced during metabolism
negative feedback is _________ and positive feedback is _______
negative feedback=homeostatic positive feedback=non-homeostatic
what type of feedback regulation does the baroreceptor reflex have
negative,
conscious discrimation of odor depends on ____
neocortex (orbitofrontal and frontal cortices)
what is the net filtration pressure equation in the kidneys
net fiiltration pressure(10mmHg)= glomerular hydrostatic pressure -bowmans capsule pressure -glomerular colloid osmotic pressure bowmans doesnt have a colloid osmotic pressure because no proteins are allowed through
during the intestinal phase of acid secretion what happens in response to increased H+, distention, osmolarity and fats in duodenum?
neural reflex to inhibit enteric neurons from stimulating (parietal, ECL and g-cells) enterogastrone release (CCK, secretin, GLP-1, GIP) all of these inhibit G-cells, ECl cells and parietal cells Increased H+ stimulates somatostatin releasing cells which inhibits ALL of those cells too
what things can binding of antigen binding site an antibody with an antigen do
neutralization-covers biologically active portion of toxin agglutination-clumping precipation-forms insoluble complex
what is the acroynm for remembering relative levels of immune cellls
never let monkeys eat banannas neutrophils, lymphocytes, monocytes, eosinophils and basophils
is there a problem if a mother is Rh+ and a baby is Rh-
no
is venous return primarily done by pressure gradients?
no bro its too small need valves thoracic pump skeletal muscle pump
are mesangial cells part of the filtration barrier?
no bro they are NOT
does bicarbonate(HCO3-) directly get reabsorbed on the apical membrane
no it doesnt! H+ must first be secreted into the lumen via a Na+/H+ antiporter where it then combines with lumenal HCO3- to become H2CO3 which is then converted into CO2 and H2O and CO2 directly diffuses into the membrane and recombines with H2O and becomes H2CO3 which is converted into HCO3- and H+ HCO3- is then transported with a Na+/HCO3- secondary active symporter into the interstitial fluid both of those require carbonic annhydrase and H+ secretion into the lumen
do proteins get filtered out into bowmans space?
no only prot free fluid
would Alpha 1 receptors and muscarininc receptors ever exist on the same cell
no.... that would make no sense alpha 1 causes SM contraction for sympathetic purposes and Mreceptors cause SM contraction for parasymapthatics
what are the three types of chronic pain
nociceptive neuropathic (hyperalgesia) mixed
what are the sympathetic actions in reflex control
norepinphrine release from postganglionic neurons to skeletal muscle arterioles---> activate alpha receptors and cause vasoconstriction Adrenal medulla- increases plasma epinephrine which activates alpha receptors (vasoconstriction) and B2 receptors Vasodilation of the heart
hemoglobin S (sickle cells) has ______ alpha units, ______ beta units and has a _________ affinity for O2 than Hb A(normal)
normal alpha units abnormal beta units sickle cell shape when deoxygenated lower affinity for O2
eupnea=
normal breathing
eupnea=
normal quiet breathing
under normal conditions O2 transport into the pulmonary capillaries is _________ limited but in fibrosis, emphysema and strenous excercise it is ________ limited
normal=perfusion limited bad stuff=diffusion limited
if you increase Kf but make no changes to Pc, colloid osmotic pressures or Pif what will occur?
normally there is NET filtration into the capillaries increasing Kf (water permeability of the capillary) will thus increase the net filtration even more!
PaCO2 increases detected in the peripheral receptors (aortic and carotid bodies) will be ________powerful as response to central changes in PaCO2 and it responds ________
not as powerful BUT response is 5X quickier than the central chemoreceptors
in cystic fibrosis what happens to intestinal flow?
not enough fluid movement
agnosia=
not knowing how to interpret a sensory perception loss or damage of an association area
what are the secretions in the jejunum
nothing (trick question)
erythrocyte cells contain NO
nucleus or organelles no DNA, NO centrioles
left shift (<59 degrees)
obesity pregnancy left venticular hypertrophy at the end of deep expiration
how is H2O and Na+ lost
obligatory loss, sweat, GI
obstructive lung diseases are caused by _______ whereas restrictive lung diseases are caused by _____
obstructive lung disaesase are due to increased Airway resistance(slow deep breaths) restrictive disease are due to decreased lung compliance
what are the cells and glands involved in the olfactory membrane
olfactory cells are primary afferent neurons sustentacular/supporting cells basal cells bowmans glands
what creates internodes in the.... CNS PNS
oligoendrocytes-forms myelin in CNS Schwann cells-forms myelin for axons in PNS
where do thiazide diuretics act?
on the Na+/Cl- transportor on the apical side of the Early Distal Tubule
the ascending sensory tract of the dorsal column pathway will ascend of the _____________ side as the stimulus and the second order neuron crosses over _________
on the same side as the stimulus and crosses over in the medulla
what is the pressure gradient available for venous return?
only 15 mmHg which is not suffient to move blood back to the heart
where does vitamin b12 bind intrinsic factor?
only once it reaches the duodenum in a pH neutral environment and the R-binding protein is broken down
what can create "leak currents"
open channels in the membrane always open and ions freely flow through via faciliated diffusion
how can you create an IPSP at a post synaptic event
opening Cl- channels increased K+ conductance (opening K+ channels)
how can you create an EPSP at post synaptic event
opening Na+ channels closings K+ and/or Cl- channels
what does the conscious discrimination of odor depend on?
orbitofrontal and frontal cortices
when looking at osmolarity you look at the _____ but tonicity is defined by _______
osmolarity=total free solute concentration, permeable and impermeable solute tonicity=defined by the number of impermeable substances
what is colloid osmotic pressure in Capillary (Pic)
osmotic force created by impermeable plasma proteins absorptive force 28mmHg
what happens to jaw muscles in terms of fiber types with aging
overall decrease in jaw muscle size with age which means that the porption of type I fibers decreases compared to type II and the type II types will increase REMEMBER: type 1 JAW muscle=larger than type II jaw muscle. This opposite to the relationship in the other skeletal muscle where type IIA/B are both larger than type I
what is the difference between oxyntic glands (fundus) and pyloric glands (antral)
oxyntic-abundant parietal and chief cells (pepsinogen) pyloric gland (antral)
what pH is required to activate pepsinogen into pepsin
pH less than 5 needed inactivated by pH greater than 5
pepsin is inactivated by
pH>5
gastric peristalsis and trituration is controled by what
pacemaker cells called interstitial cells of cajal slow waves or basic electrical rhythm BER of stomach contractions that force chyme to mix and contraction of the pyloric sphincter to slow emptying into the duodenum
where are two places the interstitial cells of Cajal are found and what processes are they involved in
pacemaker cells for BER waves Stomach (gastric/peristalsis/tituration)-3/mi and Small intestine-feeding pattern
whats the most common symptom of disease?
pain
what is acute pain?
pain lasting les than 6 months
what reflex stimuli will decrease MAP
pain originating in the viscera or joints Sleep Happy Mood
starch and glycogen (carbs) are digested by ______ in the _______ of the small intestine
pancreatic amylase in the lumen
describe the digestion and absorption pathway of polysaccharides (carbs) in the small intestine
pancreatic amylase in the lumen breaks polysaccharides into maltose which is then broken down into monosaccharides (fructose, glucose, and galactose) by brush border hydrolases Fructose is uptaken on the apical side via a passive GLUT transporter and expelled on the basolateral side passively as well Glucose and galactose use a SGLT (Na+ secondary active) transporter to enter the cell on the apical side and leave via passive transport by GLUT on the basolateral Na+ is removed on the basolateral via a Na+/K+ ATPase K+ leaks back out on the basolateral via a channel
duct cells=
pancreatic exocrine cells that secrete bicarbonate and water
acinar cells
pancreatic exocrine cells that synthesize and secrete hydrolase
what cells secrete calcitonin?
parafollicular cells of the thyroid
during the cephalic phase of GI acid secretion what happens in response to the sight of food, smell of food, taste of food, thoughts of food
parasympathetic preganglionic neurons act on the enteric neurons to stimulate them to release Ach to stimulate parietal cells, also stimulate ECL (histamine) and G-cells (gastrin) combined effect is stimulation of HCl release from parietal clels
stimulated saliva produyction is manly from what gland
parotid
what does the posterior pituitary(neurohypophysis) consist of?
pars nervosa and infundibular stalk
what is the pre-Botzinger complex
part of the ventral respiratory group-nuycleus ambiguus and nucleus retroambigus have respiratory pacemaker control
henrys law staes that
partial pressure is related to concentration of dissolved gas over solubility coefficient concentration of discolved gas = solubility x partial pressure
in transcellular sodium reabsorption in the renal tubules transport is _______across the apical side and it is _______ across the basolateral side
passive across the apical side BUT IT MAY BE SECONDARY active if tied to reabsorption of another substance like glucose Active across the basolateral membrane
passive filling of the ventricles accounts for _______% of blood for contraction active filling (artial systole) accounts for filling_______% of the blood for contraction
passive=80% active from aterial filling=20%
what are signs and symptoms of restrictive respiratory diseases (low compliance)
patient breathes fast and shallow increased respirtory rate chronic cough (dry, non productive) polycythemia due to hypoxia
what is pendrin and where is it located?
pendrin is the Cl-/I- antiporter that brings iodine into the thyroid colloid on the apical side of the follicular cell.
what type of hormone is GH?
peptide hormone
how do you calculate hematocrit
percentage of total blood volume occupied by RBCs =height of the RBCs/total height of centerfuged blood
what molecules do CD8 t cells secrete
perforin granzymesc
what are the only chemoreceptors that respond to O2 levels. what specically do they respond to
peripheral chemorecepotrs sensitive to low PaO2, high PaCO2 and low pH ONLY SENSITIVE to DISSOLVED GAS
what are the only receptors that check O2 levels
peripheral chemoreceptors
what receptors are used to regulate respiration in chronic respiratory problems?
peripheral, so O2 levels become more important in control of breathing
deficiency of vitamin B12 can cause what?
pernicious anemia because B12 is important in red blood cell production Side note: intrinsic factor is required to absorb B12, iron and calcium and its function is reduced without HCl
what enzyme is needed for iodination of tyrosine to create T3/T4
peroxidase
what happens in wernickes aphasia?
person can understand spoken or written work but is undable to interpret the thought that is being expressed
what happens with damage to brocas area
person has expressive or non-fluent aphasia inhibity to vocalize words
in cardiac contractile cells AP what is the function of the two K+ channels
phase 2: transient K+ channels CLOSE during plateu phase, this slows K+ movement out phase 4: Slow K+ channels open to repolarize
slow K+ channels are open in what phase of contractile cell AP
phase 3
describe APs in contractile cells of the heart
phase 4-resting phase 0-depolarization occurs and Fast voltage gated sodium channels open and depolarize the cell phase 1-partial repolarization for sodium channels closing phase 2- L-type Ca2+ channels open and transient K+ channels close to maintain a plateau Phase 3- repolarziation by L-type Ca2+ channels closing and slow K+ channels opening
what type of adaption do hair end organs exhibit?
phasic (fast)
phasic adaption is ________ and tonic adaption is _______
phasic adaption is fast, pacinian corpsucle tonic adaption is slow,
what enzyme catalyzes the conversion of NE to EPI? where does this occur?
phenylethanoalamine N methyltransferase in adrenal medula
what two things get phosphorylated(activated) when epinephrine and norepinephrine bind B1
phospholamban--->activates Ca++ ATPase on SR V-gated gated Ca2+ channels----> more Ca2+ enters from ECF
what are the four organic molecules that make up the plasma membrane
phospholipids steroids proteins carbohydrates
what specifically inactivates calponin and caldesmon
phosphorylation by active calcium-calmodulin myosin light chain kinase inactivates calponin AND caldesmon
what are the three types of endocytosis
pinocytosis, phagocytosis, receptor-mediated endocytosis
what is the main cause of acromegaly(Adults)/ gigantism(childern)?
pituitary tumor
cerebrocerebellum (lateral zones)=
planning and timing of sequential movement
what makes 55% of whole blood
plasma H20 + dissolved substances
amount of O2 bound to Hb depends on
plasma PO2 number of binding sites in RBCs
where is IgA synthesized
plasma cells in exocrine glands
what is the only absoprtive force in the pulmonary capillaries
plasma colloid Osmotic pressure 28mmHg
what are the two conductors of membrane potential and what is the insulator
plasma membrane is the insulator while ECF and ICF are the conductors
what percentage of body weight are the following: Plasma Interstitial fluid intracellular fluid total body water
plasma-4-5% Interstitial-20% Intracellular- 40% total body water =60% bw
von willebrand factor is necessary for
platelet activation
what is the only treatment for thrombocytopenia
platelet transfusion
what steps lead to platelet plug and vasoconstriction
platelets stick to damaged endothelial cell surface (Von Willebrand Factor) 1. platelets release contents of secretory vesicles 2. stimulate production of Thromboxane A2 from platelet plasma membrane these will vasoconstrict the damaged vessel and lead to platelet plug formation through + feedback loops
what are the lifespans of platelets? what about RBCs
platelets-10 days RBCs-120 days
what is the renal threshold. Once this is reached what happens?
point at which the plasma concentration saturates the transporters or carriers in the renal tubules (tubular load) once transport maximum is reached, further increases in tubular load are not reabsorbed and are excreted
Pontine Reticular nuclei are _____________ and medullary reitcular nuclei are _______
pontine=excitatory (helps balance body against gravity) medullary=inhibitory(balances out excitatory input from pontine)
factors that increase HR are called while factors that decrease HR are called?
positive chronotropic factors=increase HR negative chronotropic factors=decrease HR
blood clotting has a ________ feedback system
positive feedback clotting releases factors to stimulate more clotting and is only shut off when the clot seals the break (outside stimuli)
what does a positive net filtration indicate? what about negative
positive=net filtration negative=net absorption
pepsins actions=
positively feeds back to increase activation of pepsinogen into pepsin it also breaks proteins into peptides within the stomach but protein digestion is not significant in stomach
where are folliate papilla located?
posteriolateral surface of tongue
Neurohypophysis=
posterior pituitary
which pituitary contains axon terminals of hypothalamic neurons and is NOT a true endocrine gland
posterior pituitary
difference on the apical side transport in prandial vs post prandial
prandial (SGLT)- Na+ and glucose in post prandial-Cl- in and Na+ in (H+/Na+ secondary active transporter, Cl-/HCO3-)
difference on basolateral side transport in prandial vs post prandial Surface cell states
prandial state(GLUT2 transport) post prandial (K+/2Cl-) secondary symporter (moves both K+ and Cl- out) BOTH STATES REQUIRE 3Na+/2K+ ATPase
what system and receptor sets the default HR
predominant tone is set from PNS M2 receptor
what are the parasympathetic effects on saliva production
predominate regulator of saliva production critical for intiation and sustaining saliva secretion vasodilation of blood vessels 20x increase in slaiva production by acinar cells contraction of myoepithelial cells that increase flow rate
stroke volume is influenced by what three changes
preload (EDV) afterload (blood pressure) contractility (force of contraction)
what causes the illeocecal sphincter to relax and excites peristalsis?
pressure and chemical irritation in the illeum causes the relax sphincter and excite peristalsis
pressure damping in capillaries is due to _______ while decrease in velocity is due to _______
pressure damping is from decreased flow? Velocity decrease is from increasing the total surface area V=Q/A
what determines the magnitude and direction of fluid movement (absorption and filtration) in bulk flow between plasma and interstitial fluid
pressure gradient
what causes the illeocecal sphincter to contract and inhibits peristalsis
pressure or chemical irritation in the cecum on the colon
what is osmotic pressure
pressure required to STOP the flow of water into a compartment
presynaptic inputs (axoaxonal synapses) change ________ while post synaptic inhibitors/facilitates change
presynaptic Change AP size postsynaptic-change the graded Potentials (IPSP,EPSP)
what is the function of the papillary muscles and what fibers feedthem to contract
prevent prolapse of AV valves during ventircular contraction by tightening the chordae tendineae purkinje fibers supply them
what is the main function of the glomerulotubular balance
prevents overloading of distal nephron when GFR increases increases reabsorption rate when GFR increases
which is faster at conduction, muscle spindle (primary ending) or secondary ending?
primary
describe Gastric H+ Secretion
primary active antiporter (H+ out against gradient K+ in against gradient) apical side moves H+ and K+ up gradients but in opposite directions
olfactory cells unlike taste receptor cells are _______
primary afferent neurons taste receptor cells are just epithelial cells
what endocrine disorder would cause hypercalcemia, low phosphate levels, and HIGH alkaline phosphatase?
primary hyperparathyroidism increased hypercalcemia via increased osteoclasts activity increased alkaline phosphatase from increased osteoblast activity
is addisions primary or secondary?
primary hypoadrenalism
what are two other causes of polyuria besides the two types of diabetes insipidus
primary ingestation of excess fluid (primary polydipsia) Increased metabolism of ADH (in pregnacny)
what are the two cell types of the late distal/cortical collecting duct
principal cells (60-70%) of cells site of aldosterone and ADH action (reabsorb Na+ and H2O and secrete K) Intercalated cells (alpha and beta)
what does aldosterone do to the following? principal cells? intercalated cells?
principal cells=Na+ reabsorption and K+ secretion Intercalated cells=H+ secretion
what is active hyperemia
process in which an increase in tissue blood flow accompanies an increase in metabolic activity
what is the endocrine function of the heart
produces atrial natriuretic peptide in response to high blood pressure this causes Na+ and water excretion in the kidney which reduces blood volume and thus stroke volume which reduces CO and MAP
what is the capillary filtration coefficient (Kf)
product of the permeability and surface area of the capillaries Kf=hydraulic conductivity x surface area
what is a first degree heart block
prolonged PR interval (>.2 s)
what is ACTH's preprohormone? and what other things are created by it
proopiomelanocortin (POMC) Melanocyte stimulating hormone (MSH) B-endorphin B-lipotrophin
what is the preprohormone for ACTH what else is made by it
proopiomelanocortin(POMC) makes melanocyte stimulating homrone B-endorphin B-lipotropin
smooth muscle contraction may cause
propulsion or resistance
PGI2=
prostacyclin
prostacyclin=
prostaglandin same thing
what stimulates mucus secretion from the mucosal cells of the stomach to form the hydrophobic barrier of gastric mucosal barrier
prostaglandins
What are all of the metabolic results of GH release
prot synthesis Glycogen synthesis insulin resistance lipolysis IGF-1 release LOCAL tissue growth (Via IGF-1 in a paracrine fashion OR endocrine (from liver) )
what metabolic processes will increase acid production in the body
protein catabolism phosphilid catabolism exercise, hypoxia post absorptive state, diabetes mellitus nucleoprotein metabolism
brush border protein digestion is from __________ brush border carbohydrate digestion is from _________
protein-peptidases--->produce amino acids carb-hydrolases ---->produce monosaccharides
what are the intracellular buffers
proteins(like Hb/deoxyHB) Organic phosphates (ATP, ADP, AMP, glucose-1-PO4, 2,3-DPG)
why doesnt the pancreas digest itself
proteolytic enzymes stored and secreted as inactive precursor and activated in intestinal lumen enterokinase activates trypsin also tryspin inhibitors are synthesized and stored and secreted with the precursors
what activates thrombin
prothrombin activator (complex of Xa/Va) converts prothrombin into thrombin
Protein(amino acids) and fatty acids ______ stimulate I cells to release CCK and monitor peptide from the pancreas ______ stimulates the I-cells to secrete CCK
prots-->trypsin-->AAs and fatty acids INDIRECTLY stimulates I-cells via CCK-RP release pancreas DIRECTLY stimulates via monitor peptide release
what does the dorsal respiratory group do?
provides excitatory inspiratory stimuli to phrenic motor neurons (sets basic rhythm for breathing by setting frequency of inspiration via a central pattern generator)
where is H+ secreted in the nephron
proximal tubule, TAL and early distal tubule
angiotensin II acts on _______ tubules and does _______
proximal tubule, TAL of henle, distal tubule, collecting duct Increased NaCl and H2O reabsorption increased H+ secretion
where does secondary active H+ secretion and 95% of HCO3- reabsorption occur in the nephron
proximal tubule, TAL, and early distal tubule
sensory neurons are typically what structural classifications?
pseudounipolar neurons, bipolar
what nerve allows you to avoid shitting yourself
pudendal nerve controls the external anal sphincter to prevent involuntary bowel movements
why would heart failure increase hydrostatic fluid capillary pressure
pulmonary edema is from left heart failure(more into pulmonary circulation than out into systemic) systemic edema could be caused from right heart failure (fluid build up in the venous system)
what is the difference between pulmonary fibrosis and cystic fibrosis
pulmonary fibrosis is a restrictive lung disease with DECREASED COMPLIANCE, breath shallow and fast cystic fibrosis is an obstructive!!! lung disease with increased resistance, loss of Cl- channel results in thickened mucous
what is cardiogenic shock
pump failure of the heart
what park of the heart has the HIGHEST conduction velocity
purkinje fibers
what V-gated Na+ has a _________ activation gate but a ________inactivation gate
quick activation gate (at threshold opens fast) slow inactivation gate (slowly closes at threshold depolarization)
how is hyperthyroidism treated
radioactive Iodine thyroid ablation or antithyroid drugs(propylthiouracil or methimazole)-surgery is rarely indicated propanolol (b-blocker)-treats cardiovascular symptoms L-thyroxine is adminstered after thyroid is destroyed
Hair end organs detect hair movement and have _________ adaption
rapid (phasic)
what happens in acute hypoatremia
rapid decrease in Na+ in the ECF caused by loss of Na+ or excess H2O H2O into the cells swelling of the brain tissue
what is kinesthesia?
rate of movement sense or dynamic proprioception
what is the equation for rate of movement?
rate of movement= alpha (T)/(M) where T=temp, M=mass thus lower mass and higher temps=greater rate of movement
NT action is terminated by what three things?
re-uptake by presynaptic membrane absoprtion by glial cells inactivation by enzymes in the synapse
responses of cells to chemical signals is _______ mediated
receptor mediated NOT SIGNAL MEDIATED this means that two different ligands binding the same receptor will cause the SAME response but one ligand binding two DIFFERENT receptors will two different responses
what is IgD
receptor on B lymphocytes that aids in antigen recognition by B lymphocytes
where are the peripheral chemoreceptors located which cranial nerves control which?
receptors are located on the aortic and carotid baodies Glossopharyngeal nerve CNIX=carotid body Vagus nerve CN X=aortic body
what is MHC class I's purpose
receptors on all cells, CD8 T-cell interaction causes destruction of cells when it presents foreign antigens
motor units are recruited in order of _______ where _____ are recruited first and the __________ control fewer fibers
recuited in order of size where smaller motor units are recruited first and smallest motor units control fewer fibers
what cell type is always permeable to urea and glucose
red blood cell, RBC (ALWAYS PERMEABLE to those)
what carries 65% of the bodys Iron
red blood cells
what are the ONLY cells that dont have MHC class I
red blood cells all nucleated cells have them
what gives rise to the rubrospinal pathway
red nucleus in the midbrain
how do Ca2+ channel blockers treat hypertension
reduce entry of Ca2+ into vascular smooth muscle cells causing them to contract less strongly and lowering total peripheral resistance but they increase risk of heart attacks
bile salts and lecithin do what to interfacial surface tension of fat?
reduce interfacial surface tension
proton pump inhibitors do what to intrinsic factor?
reduce its function BUT DO NOT inhibit its secretion
what do aldosterone antagonists do
reduce levels Na+/K+ ATPase, ENaC, K+ channel through blocking the aldosterone receptor this will increase levels of the Na+ in the filtrate decrease levels of Na+ in the cells of the late distal collecting tubule decrease Na+ in the interstitial
what happens during mechanical digestion of mastication
reduce particle size break up cells breakup indigestible cellulose (fiber) increase surface area and decrease particle size for mixing with digestive enzymes
what happens to compliance in ateriosclerosis
reduced compliance
tension is reduced if ________(two things)
reduced if the muscle is not stretched enough or if it is stretched to much
hypodipsia can cause
reduced intake of water due to lack of thirst which can cause Hyperatremia
how can tachycardia DECREASE CO
reduces amount of time for filling to occur which reduces the EDV thus decreases CO
hypercalcemia does what to Vm
reduces membrane excitability Ca++ binds to the surface of Na+ channel settings their excitable state higher says different on the Synapse lecture........
what will aortic stenosis do to pulse pressure?
reduces stroke volume, thus reduces pulse pressure SV/C=PP
surfactant does what
reduces surface tension, and equalizes pressure between alveoli of different sizes
what prevents backward conduction during an AP
refractory period inactivation gates on the V-gated Na+ channels AND loss of K+ through v-gated K+ channels
the law of LaPlace describes what in lungs
relationship between surface tension and radius of an alveolus P=2T/r P=collapsing pressure T=surface tension r=radius
most antigens on RBCs are ______
relatively weak
Beta 2 receptors act to
relax smooth muscle release FA and glucose through Gs protein and increased cAMP signaling
in low O2 are capillary spincters relaxed or contracted?
relaxed
gastrin secretion from G cells will stimulate what?
release of histamine from ECL cells (histamine stimulates parietal cells to release HCl/intrinsic factor) gastrin also directly stimulates parietal cells to secrete HCl/intrinsic factor
what provides the energy for the power stroke?
release of inorganic phosphate from the myosin head
somatostatin is released in response to_____ inhibits ________cells
released in response to low luminal pH in stomach by d-cells inhibits G-cells (gastrin), ECL cells (histamine) and parietal cells
all preganglionic terminals of SNS AND PNS release what NT? and what does it bind on a postganglionic neuron
releases ACh which binds to nicotinic receptors Type Nn on the post ganglionic neuron
what is myosin light chain phosphatase
removes phosphate and stops contraction in SM
respiratory acidosis or alkalosis will use what compensation mechanism
renal compensation HCO3- reabsorbed more in acidosis
what does renin ultimately do to GFR and how
renin secretion via the JGA cells in response to signals sent by the macula densa detecting low Na+ in the TAL(excesssive reabsorption due to low GFR) will cause creation of ANG II which increases efferent arteriole resistance and decrease afferent arteriole resistance to increase Pg and increase GFR
what is the zona glomerulosa controlled by?
renin-angiotensin-aldosterone system (RAAS)
what is the purpose of breaking down fats in the lumen of the intestine if we just absorb the breakdown products and resynthesize in the intestinal cells?
repackaging the FA and MGs into triglycerides keeps a favorable diffusion gradient into the cells from the intestinal lumen
after activation T and B lymphocytes will _________ and get secreted into the lymphatic circulation
replicate into clones
repolarization= hyperpolarization=
repolarization Vm change that restores Vm hyperpolarization=Vm becomes more negative than rest
What factors influence pressure pulsation (damping)
resistance and compliance increased resistance or elasticity with increase damping of pressure
kidneys do what in response to chronically elevated PaCO2/high CSF H+
resorb more Bicarbonate which prevents central chemoreceptor action and peripheral chemoreceptors take over
metabolic acidosis or alkalosis will use what compensation mechanism?
respiratory acidosis=increase ventiliation and decrease Pco2 alkalosis=decrease ventilation and increase Pco2
hyperventilation will do what to the acid base balance
respiratory alkalosis
where does the respiratory zone of the lungs begin
respiratory bronchioles
what inhibits I cells? what makes this a unique feedback system?
trypsin inhibts I-cell CCK release as protein levels decline trypsin is freed up to act on I cells and prevent CCK release
what diseases can effect bowmans capsule hydrostatic pressure (Pb)
tubular obstruction (kidney stones, tubular necrosis) Urinary tract obstruction (prostate hypertrophy/cancer)
what diseases can affect GFR through changes in the pressures of Bowman's capsule? (PB)
tubular obstruction(kidney stones, tubular necrosis) Urinary tract obstruction(prostate hypertrophy and cacner)
the diffusing capacity of the lung measures _________
respirtory membranes functional integrity
pulmonary fibrosis is a ______ disease that _______ compliance causes ________ breathing
restrictive lung disease decreases compliance fast shallow breaths
pneumonia and pulmonary edema are _________ lung disease
restrictive, low compliance
What brainstem pathway provides necessary background muscle contractions for standing against gravity and to inhibit groups of muscles as needed so that other functions can be performed
reticulospinal descending pathway Reticular nuclei activity adjusted by the cerebral cortex to accomplish this
what is the leading cause of blindness in the US
retinopathy
what are the functions of the lymphatic system
returns 3L of filtered fluid and proteins a day to the circulation transports absorbed fat from small intestine to circulation immune system functions
3 functions of the lymphatic system
returns filtered fluid and proteins to circulation transporting absorbed fat from small intestine to circulation immune system
which ventricle generates smaller pressure? If both ventricles pump the same volume of blood why does one have a smaller pressure?
right ventricle has smaller pressure pulmonary circulation has lower resistance than systemic so less pressure needed
tall lanky people would more likely have _______ ventircular hypertrophy
right ventricular hypertrophy right shift >59
what type of sensory receptors are found in the periodontal ligament?
ruffini endings
what receptor is involved in Ca2+ induced calcium release? what muscles have this?
ryanodine receptors cardiac AND smooth
what happens to tubular reabsorption when there is an increase in filtered load
tubular reabsorption increases with a filtered load IT DOES NOTTTT remain constant
what is the functional unit of cardiac and skeletal muscle
sarcomere
what is the average SaO2
saturation of hemoglobin is 97% on average
describe why you cant survive drinking seawater
seawater has an osmolarity of 1200 mOsmol your body has endogenous osmotic load that is normally 600 mOsmol/day if you add 1200 + 600=1800mOsmol if you look at obligatory urine volume with this.... 1800/1200=1.5 L/day you divide osmotic load by the maximal concentration of urine (1200) and you will find that you have to excrete 1.5L/day to balance osmolarity this means you're excreting more fluid than you consumed in the water sooo dehydrates yo asssss
what recieves the taste sensory input from the first order neurons?
second order neurons in the medulla Nucleus tractus solitarii
what does band 3 protein do
secondary active antiporter between Cl- and HCO3 in systemic tissues it takes HCO3 out of the RBC and into the plasma and brings in Cl- in pulmonary tissues it brings HCO3- into the tissue and Cl- out
I-cells secrete ____ when stimulated by???
secrete CCK when stimulated by CCK-RP and monitor peptide
what do CD8 cells do when activated by binding antigens on MHC Class I
secrete perforin molecules that punch holes in membrane and lyse the cell release cytoxic substances (granzymes) into the target through perforin channels that stimulate apotosis
what is the stimulus for ANP release?
secreted by cardiac atria in response to stretch (increased BV)
what stimulates liver ductal cell secretions(HCO3_+
secretin
what hormones inhibit the feeding pattern int the SI
secretin and glucagon
what hormones inhibit the feeding pattern of the small intestine
secretin and glucagon
the secretion rate of the pancreatic juice is a function of
secretin concentration Ach concentration CCK concentration
at what pH is there secretin release? what about maximal secretin release?
secretin released when pH is <4.5 max secretin at pH=3
IgA immunoglobin properties (3 things)
secretory Ig, synthesized by plasma cells in exocrine glands most abundant Ig in the body (mucosal sites) mucosal immunity and neonatal immunity
segmentation of the small intestine in the feeding patterns does what? peristalsis does what?
segmentation=mixing (chyme with digestive enzymes, emulsifies fats, adjusts pH and exposes mucosa to chyme) peristalsis=propel chyme through SI at 1cm/minute, spreads it across mucosal surface
what conditions could inhibit deiodinase activity:
selenium deficiency, burns, trauma, advanced cancer, cirrhosis, chronic kidney disease, MI and febrile states (fasting and stress)
during late ventricular systole what valves are open/closed
semilunar valves are open for business but the AV valves are shut
Ruffinis endings detect what sensatoins and where are they found
sensitive to stretch or indentation and used for proprioception layers of the skin, joints and surrounding tooth roots slow adaption/tonic
the 1b and 1a fibers are ______ fibers. What does each receive sensation for
sensory fibers 1a fiber=muscle spindle 1b fiber=golgi tendon
what lies beneath the longitudinal muscle of the muscularis externa GI layer
serosa
what causes myxedema
severe hypothyroidism Increased quantities of hyaluronic acid and chondroitin sulfate bound with protein plus water accumulate in skin.
what diseases can cause secondary hypertension
tumor of adrenal medulla(epi release) cushing disease (glucocorticoid excess) atherosclerosis of the renal arteries Renal hypertension ateriosclerosis hyperthyroidism (T3/T4 excess)
what neural controls stimulate oxyntic cells and parietal cells
short reflex-stretched gastric wall stimulates ENS to release ach/GRP which stimulates cells long reflex- vago vagal travels to dorsal vagal complex and then Ach travels back down to oxyntic gland and GRP travels to G cells to stimulate gastrin release--->both stimulate parietal and chief cells
what is the baroreceptor reflex
short term response to changes in blood pressure NS mediated homeostatic process alters CO and TPR to restore MAP to homeostatic levels overrides local control of blood flow
what type of flow in in large vessels like aorta and pulmonary
turbulent flow
what is the difference between myosin ATPase activity and SR Ca++ ATPase capacity in type I fibers
type 1 has MODERATE SR Ca++ ATPase capacity and SLOW myosin ATPase activity
dsecribe relative size of fibers in the JAW!!!!! type I Type IIA/B
type 1 jaw muscle has large fibers with type II jaw muscle is much smaller
give relative diameters of type I, IIA and IIBmuscle fibers
type 1=small Type 2A=moderate type 3B=large
what are the cell types in the alveoli
type I cells- simple squamous epithelial cells type II cells-produce surfactant macrophages
which cell produces surfactant and why is surfactant needed
type II alveolar cells needed for inspiration, makes breathing easier
which hypersensitivity is delayed
type IV
what is the short term mechanism of regulating MAP what is the long term mechanism
short term-barareceptor reflex long term- blood volume change (raise blood volume to raise blood pressure, lower blood volume to lower blood pressure)
what stimulates the Cephalic phase of acid secretion?
sight of food smell of food taste of food thoughts of food
difference between a sign and a symptom
sign=objective evidence that can be seen or measured (large hands, polyuria, tachycardia) symptoms=cannot be measured more subjective, pain, numbness
describe the signal sent by the dorsal respiratory group for inspiration
signal begins weakly, increases steadily for 2 seconds and then with abruptly cease for 3 seconds before resuming the cycle MIRRORS activity of diapragm
what types of cells are in the epithelial layer of the GI tract
simple columnar (microvilli) Goblet cells enteroendocrine stems
what is contained within the epithelial layer of the GI tract
simple columnar (microvilli) goblet cells enteroendocrine cells (base of villi) stem cells
which is faster? simple or faciliated diffusion?
simple diffusion is faster
extrafusal fibers=
skeletal muscle fibers/cells that produce the contraction alpha motor neuron: efferent neuron that releases ACh and causes contraction of the extrafusal fiber (skeletal)
what is the difference in contractile response to an AP in cardiac vs skeletal muscle
skeletal muscle has an all or non response Ca++ saturates troponin and contraction strength is maximal Cardiac muscle has a graded response to a single AP, in resting state AP induced SR Ca++ release DOES NOT saturate all troponin sites
where are free nerve endings located? What type of sensation and what type of adaption?
skin, cornea, dental pulp, GI tract detect touch and pressue (temp and pain) slow adaption-tonic
what are the clinical manifestations of GH deficiency
slow linear growth rates normal skeletal proportions pudgy, youthful appearance (decreasd lipolysis) cortisol deficiency --> hypoglycemia
type I muscle fibers are _______ twitch
slow twitch
small motor units are composed of what?
slow twitch oxidative fibers they have the lowest threshold for firing and are recruited first
heart conduction blocks are caused by
slowed or absent conduction through the AV node
why do we want a slower twitch in cardiac muscle than AP
slower twitch allows for longer absolute refractory period which decreases the ability of the cardiac muscles to summate force on APs this is good for continous fluid movement
where does bicarb HCO3- get secreted from to neutralize the pH of the stomach? Which one has a larger impact? and what is the maximal HCO3- concentration
small amounts from the bile LARGE Amounts from the pancreas maximal stimulus of pancreas produces juice with HCO3- of 145 mEq/L this is wayy more than normal ECM HCO3- (24 mEq/L
what is pressure natriuresis and pressure diuresis
small increases in MAP can cause marked increases in urinary Na+ and H2O excretion mechanism not fully understood
where is 95% of carbohydrates digested?
small intestine
What type of receptive fields for warm/cold receptors are found in the orofacial region?
small receptive fields nociceptive thermal receptors have large receptive field
what are the normal hematocrit levels
women 38-46% men- 42-54%
in the collecting duct describe H+ excretion
works via ammonia and H+ (via a H+ ATPase) pump on the apical side into the lumen H+ combines with NH3-->NH4+ ammonium ion and then HCO3 is added to the ECF
what would loop diuretics do to filtrate osmolarity at the end of the loop of henle
would greatly increase filtrate osmolarity due to no reabsorption of Na+/2Cl-/K+ (inhibited transportor in TAL)
what would the following conditions do to PTH secretion? pregnacy, rickets and lactation
would increase rate of PTH secretion due to decrease in ECF Ca2+
what are the end products of intraluminal (stage I-pancreatic hydrolases) digestion?
yeilds di and tripeptides, amino acids, maltose, maltoriose, alipha limit dextrins, glucose fat digestion also completed here triglycerides
is ADH required for secretion of urea in the descending limb and thin ascending limb?
yes it is required
in a third degree heart block
you have multiple P waves(artial depolarization) without a QRS
where is aldosterone secreted by
zona glomerulosa cells of the adrenal cortex
dehydroepiandrosterone is released by what layer of the adrenal cortex?
zona reticulares it is a sex hormone precursor
what zone of the lung has the highest V/Q ratio
zone 1, APEX TOP OF LUNG
in the supine position the lungs have mostly zone _______ blood flow because ________
zone 2 because the gravity gradient is reduced when lying down
which lung zone has highest perfusion
zone 3 at the base of the lung
what is normal hemoglobin called? and give subunits
Hemoglobin A (A2B2)
where are posterior pituitary hormones stored
Herring Bodies Neurosecretory bodies
describe what happens in the thin descending limb
High H20 permeability (AQP-1 channels): major role in concentration/dilution of urine NO Active solute transport Urea secretion via facilitated diffusion
high acid=________ thus ______ parietal cell stimulation low acid=_________ thus ________ parietal cell stimulation
High acid=high somatostatin, low parietal cell stimulation Low acid=low somatostatin, high parietal cell stimulation
what are phosphate levels inside the cell vs outside
High inside low outside
what are requirements for excreting concentrated urine
High levels of ADH hyperosmotic medullary interstitial fluid -creates gradient for water reabsorption -requires the counter current mutliplier mechanisms -juxtamedullary nephrons do this
describe GH secretion levels through out life span
High secretion in neonatal period but decreases in childhood. Peak levels during puberty and then they decline with age.
what effects does ang II vasoconstriction of the efferent arteriole have on pressures ?
Higher Pg (higher pressure in the capsule=more filtration=higher GFR) Decreased Pc in the peritubular capillaries and increased colloid osmotic pressure of capillaries=more reabsorption
what are the two established PARACRINE gut factors
Histamine (ECL cells) Somatostatin (D-cells)
A good estimate for a normal A-a gradient is
The A-a gradient increases by 1 mmHg for each decade so a normal value for a 40 year old would be <14 mmHg. A good estimate for a normal A-a gradient is 8 + 20% of the patient's age.
